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Published on: March 27, 2018
Paranasal sinusitis: cryptic sepsis after coronary artery bypass operations
A L Picone1, C E Baisden, E G Ford
1Department of Surgery, Keesler Medical Center (ATC), Keesler Air Force Base, Mississippi 39534-5300.
The Annals of Thoracic Surgery
|March 1, 1993
Summary
Occult sinusitis developed in 1.3% of patients after coronary artery bypass surgery. Early diagnosis via CT scans and prompt treatment with antibiotics and drainage are crucial for recovery.
Area of Science:
- Infectious Diseases
- Surgical Infections
- Otolaryngology
Background:
- Coronary artery bypass grafting (CABG) is a major surgical procedure with potential complications.
- Postoperative infections can significantly impact patient outcomes and increase healthcare costs.
- Identifying and managing occult infections is critical for effective patient care.
Observation:
- A retrospective review identified 5 patients (1.3%) with occult paranasal sinus infections post-CABG.
- Clinical signs of acute sinusitis were absent in most affected patients.
- Computed tomography (CT) scans revealed sinus wall thickening and opacification in all cases.
Findings:
- Occult sinusitis occurred in 1.3% of 400 CABG patients.
- Only one patient presented with typical sinusitis symptoms (purulent nasal discharge).
- CT imaging was essential for diagnosing these subclinical sinus infections.
Implications:
- Risk factors for postoperative sinusitis include prolonged intubation, airway colonization, and impaired secretion clearance.
- Consider paranasal sinus evaluation in patients with unexplained postoperative sepsis.
- Prompt surgical drainage and antibiotic therapy are effective treatments for occult sinusitis.
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