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Pattern of intracranial complications of sinusitis in komfo anokye teaching hospital
Background:
Patients with intracranial complications of sinusitis present a major challenge to all, physicians, otorhinolaryngologists and neurosurgeons, because the purulent collection can be in areas that are not easily accessible like the interhemispheric and subfrontal areas of the brain and continue to exert toxic effects that account for the morbidity and mortality associated.
Aims And Objectives:
To determine the incidence, symptoms, pattern, the management and the outcome of intracranial complications of sinusitis in KomfoAnokye Teaching Hospital, Kumasi, Ghana.
Study Design:
It was a prospective study of 39 patients who presented with intracranial complicationsof sinusitis.
Setting:
The study was carried out in KomfoAnokye Teaching Hospital (KATH), in Kumasi, Ghana.
Patients And Methods:
Patients who reported to KATH with sinugenic intracranial complications from January 2007 to December 2011 were prospectively studied using a standard proforma to record details of their demographic, clinical presentations, management data and outcome.
Results:
The incidence rate of sinugenic intracranial complications was 3.2%. They consisted of 69.2% males and 30.8% females, with a male-to-female ratio of 2.3: 1 and a mean age of 25.3 years. The most common symptoms were headache in 100%, fever in 92.3%, nausea / vomiting in 30.8%, sinus tenderness in 10.3%, hemiparesis in 2.6%, proptosis in 12.8% and lethargy in 5.1% of the cases.Epidural abscess was the commonest sinugenic intracranial complication in 35.9%, sudural abscess in 25.6%, meningitis in 20.5%, cavernous sinus thrombosis in 12.8% and cerebral abscess in 5.2%. Sinus surgeries were performed in 71.8% and neurosurgical operations were also performed in 66.7% of the cases. Single modality treatment of sinus surgery was performed in 33.3% of the cases, neurosurgical procedure in 28.2% whereas a combined treatment was performed in 38.5%. The management outcomes were successful in 87.7% and unsuccessful in 2.6%.
Conclusion:
Even though the incidence rate of sinugenic intracranial complications was minimal as compared to some literatures, they still require a prompt and a collaborative management of the physician, otorhinolaryngologist and the neurosurgeon.