鼻窦炎颅内并发症的处理策略:我们的经验及文献复习。

IF 2.3 Q1 OTORHINOLARYNGOLOGY
Allergy & Rhinology Pub Date : 2022-09-25 eCollection Date: 2022-01-01 DOI:10.1177/21526575221125031
Bassel Hallak, Salim Bouayed, Joseph André Ghika, Pedro S Teiga, Vincent Alvarez
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引用次数: 1

摘要

目的:鼻窦炎或鼻鼻窦炎是一种非常常见的疾病,在某些情况下,它会导致颅内并发症(ICS)。这些在免疫功能低下患者或伴有潜在合并症的患者中更为常见,但即使是健康个体也可能受到影响。如今,由于抗生素治疗、放射诊断方法、手术技术和技能的改进,ICS已经变得不那么常见了。尽管如此,它们仍然会导致严重的发病率和死亡率。因此,这些并发症的管理需要多学科的方法来计划和定制治疗方案。本文介绍了我们处理急性鼻窦炎引起的一系列颅内并发症的策略,并将我们的经验和结果与文献进行了比较。研究设计:单研究所经验,回顾性分析系列病例和文献综述。方法:纳入2016年至2020年在瑞士锡安医院耳鼻喉科接受ICS治疗的成人和儿童患者。记录了他们的症状、病史、临床和放射学表现、治疗和结果。结果:8例患者(男6例,女2例),年龄14 ~ 88岁。没有任何慢性鼻窦炎或复发性鼻窦炎病史。此外,很少有特定的鼻症状,但有神经或其他症状。计算机断层扫描(CT)和磁共振成像(MRI)证实所有ICS的诊断。在我们的队列中观察到所有类型的已知颅内并发症,鼻窦炎的扩展范围和严重程度都很广。针对每位患者,采用多学科方法进行个体化治疗。几乎所有患者的结果都是有利的,在随访中没有复发,也没有观察到神经系统后遗症。只有一名患者因晚期肺癌的致命并发症而死亡。结论:由于大量相关的发病率和死亡率,ICS仍然是一个具有挑战性的临床问题。这些并发症的发生率相对较低。缺乏治疗管理指南。早期发现和多学科结合是成功治疗的关键。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Management Strategy of Intracranial Complications of Sinusitis: Our Experience and Review of the Literature.

Management Strategy of Intracranial Complications of Sinusitis: Our Experience and Review of the Literature.

Management Strategy of Intracranial Complications of Sinusitis: Our Experience and Review of the Literature.

Management Strategy of Intracranial Complications of Sinusitis: Our Experience and Review of the Literature.

Objective: Sinusitis or rhinosinusitis is a very common disease worldwide, and in some cases, it leads to intracranial complications (ICS). These are more common in immunocompromised patients or with underlying comorbidities, but even healthy individuals, can be affected. Nowadays, ICS have become less common thanks to improved antibiotic therapies, radiological diagnostic methods, surgical techniques and skills. Nonetheless, they can still cause significant morbidity and mortality. For this reason, management of these complications requires a multidisciplinary approach to plan and customize treatment options. This paper presents our strategy in the management of a series of intracranial complications induced by acute sinusitis and compares our experience and outcomes with the literature.

Study design: Single institute experience, retrospective analysis of cases series and literature review.

Methods: Adult and child patients who were treated for ICS in the Department of Otorhinolaryngology at Sion Hospital, in Switzerland from 2016 to 2020 were included. Their symptoms, medical history, clinical and radiological findings, treatment, and outcome were documented.

Results: Eight patients (6 males- 2 females) aged from 14 to 88 y.o., were enrolled. None had any previous history of chronic, or recurrent sinusitis. Moreover, very few presented specific rhinological symptoms, but with neurological or other symptoms. Computed tomography (CT) and Magnetic Resonance Imaging (MRI) were used to confirm the diagnosis of all ICS. All types of known intracranial complications were observed in our cohort with a wide range of extension and severity of sinusitis. A multidisciplinary approach with individual treatments was tailored to each patient. Outcomes were favorable in almost all patients with neither recurrence, nor neurological sequels being observed in the follow-up. Only one patient was lost due to fatal complications of advanced lung cancer.

Conclusion: ICS remain a challenging clinical problem due to substantial associated morbidity and mortality. The incidence of these complications is relatively low. Therapeutical management guidelines are lacking. Early detection and multidisciplinary approach are key to successful treatment.

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来源期刊
Allergy & Rhinology
Allergy & Rhinology OTORHINOLARYNGOLOGY-
CiteScore
3.30
自引率
4.50%
发文量
11
审稿时长
15 weeks
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