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A Scoping Review of the Intracranial Complications of Pediatric Sinusitis
Victoria J Cress1, Katerina J Green2, Amiti Jain3
1Department of Otolaryngology, Mayo Clinic, Rochester, Minnesota, USA.
Insights
Intracranial complications from pediatric sinusitis are rare but serious. Adolescent males are most affected, often presenting with headache and fever, requiring prompt antibiotic and surgical treatment.
Area of Science:
- Pediatric Neurology
- Infectious Diseases
- Neurosurgery
Background:
- Intracranial complications of pediatric sinusitis, though uncommon, carry significant risks, especially with delayed treatment.
- Understanding the common factors in their development and progression is crucial for timely intervention.
Purpose of the Study:
- To identify commonalities in the development and progression of intracranial complications secondary to sinusitis in children.
- To provide a foundation for improved medical and surgical decision-making in pediatric cases.
Main Methods:
- A comprehensive scoping review following PRISMA guidelines was conducted.
- Included studies focused on pediatric patients (<18 years) with intracranial infections from sinusitis.
- Data from 33 studies encompassing 1149 patient cases were analyzed.
Main Results:
- Intracranial complications were more prevalent in adolescent males.
- Common initial symptoms included headache and fever, often present for over a week.
- Subdural empyema and epidural abscess were the most frequent complications, diagnosed via CT scans.
Conclusions:
- This review highlights commonalities in pediatric intracranial sinusitis complications.
- Findings offer insights for medical and surgical management strategies.
- Further research is warranted to refine treatment protocols for this population.
Objective:
Intracranial complications of pediatric sinusitis are uncommon but are often associated with significant morbidity, especially when appropriate care is delayed. The present study aimed to identify commonalities for the development and progression of these complications in the pediatric population.
Data Sources:
CENTRAL, CINAHL, Citation searching, ClinicalTrials.gov, Embase, Google Scholar, MEDLINE, PsycINFO, PubMed, Scopus, Web of Science, and World Health Organization.
Review Methods:
A comprehensive literature search was performed using Preferred Reporting Items for Systematic Reviews and Meta-analyses scoping review guidelines. Studies describing intracranial infections secondary to sinusitis in the pediatric population (age <18 years) were included. Studies in which adult and pediatric data were not separated and studies in which the pediatric cohort was fewer than 10 cases were excluded. Ultimately, 33 studies describing 1149 unique patient cases were included for data collection and analysis.
Results:
Our analysis revealed intracranial complications were more common in adolescent males. Most children presented with over 1 week of vague symptoms, such as headache and fever. The majority of complications were diagnosed radiographically with computed tomography. Subdural empyema and epidural abscess were the most common intracranial complications reported. On average, patients were admitted for over 2 weeks. Most children were treated with a combination of antibiotics and surgical intervention. Complications were rare, but when present, were often associated with significant morbidity.
Conclusion:
This scoping review of the available literature has provided insight into commonalities among pediatric patients who develop intracranial complications of sinusitis, providing a foundation for further study to inform medical and surgical decision-making in this population.
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