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Cavernous sinus thrombosis: successful treatment using functional endonasal sinus surgery.
1Otolaryngology Consultants of Memphis, LeBonheur Children's Medical Center, TN 39105, USA.
Archives of Otolaryngology--Head & Neck Surgery
|December 1, 1993
Summary
Functional endonasal sinus surgery combined with antibiotics significantly improves outcomes for cavernous sinus thrombosis. This approach offers a better prognosis than antibiotics alone for this severe sinus infection complication.
Area of Science:
- Otolaryngology
- Neurosurgery
- Infectious Diseases
Background:
- Cavernous sinus thrombosis (CST) is a severe complication of paranasal sinus infections.
- Standard antibiotic therapy yields suboptimal outcomes, with less than 50% complete recovery and a 30% mortality rate.
Observation:
- A 15-year-old male presented with proptosis, ophthalmoplegia, and cranial nerve palsies secondary to pansinusitis and CST.
- CT scans confirmed orbital edema, pansinusitis, and thrombosis of the cavernous sinus and superior ophthalmic vein.
Findings:
- Functional endonasal sinus surgery was performed to drain infected sinuses filled with polypoid tissue and purulent material.
- Post-operatively, the patient received a 3-week course of broad-spectrum antibiotics and anticoagulation.
- The surgery restored normal sinus physiology, correlating with clinical improvement.
Implications:
- Functional endonasal sinus surgery, as an adjunct to antibiotics, can significantly improve outcomes in patients with CST.
- This surgical approach offers a promising strategy to reduce morbidity and mortality associated with this catastrophic complication.
