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Published on: July 5, 2021
Transethmoidal drainage of frontal brain abscesses
Vincent Patron1, Stéphane Orsel, François Caire
1Limoges University Hospital Center, Limoges, France, Rennes University Hospital Center, Rennes, France. vtromps@yahoo.fr
Surgical Innovation
|September 7, 2010
Summary
Endonasal transethmoidal sinus surgery (ESS) offers a feasible, minimally invasive approach for draining frontal lobe brain abscesses. This technique allows for rapid microbial identification and effective drainage, potentially improving patient outcomes.
Area of Science:
- Neurosurgery
- Otolaryngology
- Infectious Disease
Background:
- Frontal lobe abscesses are second only to temporal lobe abscesses in frequency.
- Despite advanced imaging, brain abscess prognosis remains poor.
- Standard treatment involves antibiotics and surgical evacuation, with ongoing debate on optimal approaches.
Observation:
- This study presents two cases of frontal abscesses managed with endonasal transethmoidal sinus surgery (ESS).
- A literature review on ESS for frontal abscesses was conducted.
- Post-operative follow-up showed no cerebrospinal fluid leaks in either patient.
Findings:
- One patient achieved complete abscess drainage, while the other had incomplete drainage.
- ESS is a viable option for intracerebral and epidural frontal abscesses with thick capsules near the skull base.
- The procedure is minimally invasive, simple, and facilitates rapid microbial identification and drainage.
Implications:
- Endonasal transethmoidal sinus surgery presents a promising, minimally invasive alternative for frontal lobe abscess management.
- This approach may enhance diagnostic capabilities through rapid microbial identification.
- Further research could establish ESS as a standard treatment for select frontal abscess cases.
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