Cases reported "Frontal Sinusitis"

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1/12. Subdural empyema and blindness due to cavernous sinus thrombosis in acute frontal sinusitis.

    In this era of antibiotics, the complications of acute sinusitis are much less frequently encountered. Although orbital complications are most common, intracranial complications carry a high rate of mortality and morbidity. We describe a case of acute frontal sinusitis with subdural empyema and blindness due to cavernous sinus thrombosis and carotid artery thrombosis with a discussion of treatment of these complications and the etiology of blindness in sinusitis.
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2/12. Intracranial complications of frontal sinusitis in children: Pott's puffy tumor revisited.

    The objective of the present study is to describe the diagnosis and treatment of intracranial complications of frontal sinusitis (Pott's puffy tumor) in a series of pediatric patients at our institution. A rare entity, Pott's puffy tumor has been reported in only 21 pediatric cases in the literature of the antibiotic era. The hospital records and radiographic files at Rainbow Babies and Childrens Hospital, Cleveland, ohio, USA, over the previous 16 years were retrospectively reviewed in a search for patients with the diagnosis of Pott's puffy tumor, defined as scalp swelling and associated intracranial infection. There were 6 male patients and 1 female patient. Ages ranged from 11 to 18 years (median 14.5 years). Intracranial infections consisted of epidural abscess in 5 patients, subdural empyema in 4 and brain abscess in 1. Intraoperative cultures grew anaerobic organisms in 1 patient, microaerophilic streptococcus in 5 patients, klebsiella species in 1 patient and streptococcus pneumoniae in another. All patients presented with frontal scalp swelling, and other common symptoms included headache, fever, nasal drainage and frontal sinus tenderness. Five patients were treated with antibiotics prior to their presentation. Four patients presented with neurologic decompensation characterized by varying degrees of hemiparesis, obtundation, pupillary dilatation or aphasia. All patients underwent craniotomy and evacuation of the intracranial infection. Even severely impaired patients demonstrated full neurologic recovery. Despite the widespread use of antibiotics, neurosurgical complications of sinusitis continue to occur. A high degree of suspicion, along with prompt neurosurgical intervention and the use of appropriate antibiotics, can result in favorable outcomes in even the sickest patients.
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3/12. Monostotic fronto-orbital fibrous dysplasia with convulsion--case report.

    A 28-year-old man presented with monostotic fronto-orbital fibrous dysplasia associated with convulsions. Signs of meningeal irritation were observed. Computed tomography (CT) showed right frontal sinusitis, and destruction from the inner to outer table with expansion of the diploic space. T1- and T2-weighted magnetic resonance imaging showed an abnormal low-intensity mass, with heterogeneous gadolinium enhancement. Although the meningitis resolved, signs of infection continued for 2 months due to sinusitis. Treatment of the right frontal sinusitis was undertaken, accompanied by open biopsy. The histological diagnosis was fibrous dysplasia. Once the infection had completely resolved, orbitofrontal reconstruction was undertaken. Cranioplasty was carried out using cranial bone cement. Three-dimensional CT was valuable to show the likely postoperative result.
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4/12. Subdural empyema complicating a concha bullosa pyocele.

    Concha bullosa is the most common anatomic variant of the middle turbinate and remains usually asymptomatic. We report a case of concha bullosa pyocele with a subdural empyema in a 11-year-old girl presenting with a subcutaneous tumefaction without neurologic deficit. Computed tomography and magnetic resonance imaging confirmed a subdural empyema communicating with subcutaneous effusion and the presence of a concha bullosa pyocele being responsible for the obstruction of ostiomeatal complex leading to frontal sinusitis. Resection of the middle turbinate with a middle meatotomy and a frontal skin incision combined with an adequate antibiotic treatment allowed this child to recover within 6 weeks.
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keywords = subdural
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5/12. Pott's puffy tumor of the vertex years after trauma in a diabetic patient: case report.

    Pott's puffy tumor is a rare clinical entity characterized by subperiosteal abscess associated with osteomyelitis. It is usually seen as a complication of frontal sinusitis or trauma. This is the unique report of a Pott's puffy tumor located over the vertex of a type 1 diabetic patient with an unusual latency of 14 years following injury. A 27-year old man presented with pain and a soft swelling on his vertex. magnetic resonance imaging demonstrated subperiosteal abscess in the vertex region associated with dural thickening and perisinusal irregularities of epidural space. Further history revealed that he had a trauma to the same location when he was 13 years old. Considering possible complications due to proximity of the lesion to the sagittal sinus, we retrained from aggressive surgical interventions. We treated our patient with a simple surgical abscess drainage followed by prolonged use of antibiotics and achieved complete therapy. The cellular and humoral elements of the immune system may be disrupted in diabetic patients resulting in such atypical courses and complications of infections. We want to emphasize both importance of the prompt diagnosis of Pott's puffy tumor as intracranial invasion may cause severe neurologic problems, and importance of a surgical intervention tailored for the individual lesion.
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6/12. Suppurative complications of frontal sinusitis in children.

    A retrospective review of children diagnosed and treated for suppurative complications of paranasal sinusitis was undertaken to describe clinical presentation, microbiology, and treatment. This review includes children with subgaleal abscess and osteomyelitis of the frontal bone, subdural empyema, frontal lobe abscess, meningitis, and encephalitis. staphylococcus aureus and group C beta-hemolytic Streptococcus were isolated agents. All children were treated with intravenous antibiotics with drainage of both the sinus and extracranial and intracranial suppurations. Results of treatment in the series support the opinion that combined aggressive surgical and antibiotic treatment is a preferred method in complicated sinusitis in children.
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7/12. Molecular identification of rhizomucor pusillus as a cause of sinus-orbital zygomycosis in a patient with acute myelogenous leukemia.

    Sinus-orbital zygomycosis caused by rhizomucor pusillus in a patient with acute myelogenous leukemia is described. Identification was achieved by sequencing of the internal transcribed spacer (ITS) regions of the rRNA gene and by expression of zygospores in mating. This report highlights the value of ITS sequencing as a diagnostic tool for the identification of R. pusillus and expands the understanding of infection types caused by this zygomycete.
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keywords = space
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8/12. Pott's puffy tumour and subdural empyema following frontal sinusitis.

    A previously healthy 17-year-old lad presented with purulent sinusitis and subsequently developed subdural empyema in association with Pott's puffy tumour. Complete resolution occurred with an intensive antibiotic regime and drainage of the subgaleal space.
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ranking = 5.0016897497158
keywords = subdural, space
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9/12. Epidural-cutaneous fistula in association with the pott puffy tumor in an adolescent. Case report.

    The pott puffy tumor is a subperiosteal abscess associated with underlying osteomyelitis, most often of the frontal bone in conjunction with frontal sinusitis. Intracranial sequelae can include epidural abscess, subdural empyema, intraparenchymal abscess, meningitis, and dural venous thrombophlebitis, all with resultant neurological deterioration. Although once common, this entity has become rare since the introduction of antibiotic agents. The authors present an unusual case of a 14-year-old girl suffering from the pott puffy tumor whose condition was further complicated by a draining epidural-cutaneous fistula and an epidural abscess.
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keywords = subdural
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10/12. diagnosis and treatment of intracranial complications of paranasal sinus infections.

    Complications and local extension of paranasal sinus infections most often involve the orbit and periorbita. Because of the widespread use of antibiotics since world war ii, intracranial extension of maxillofacial sinusitis is rarely seen today. Nevertheless, the clinician must be aware of the potential for these complications, because late recognition of this condition and delays in treatment can increase morbidity and mortality rates. A comprehensive, current review of sinogenic intracranial complications is presented, with illustrative cases of brain abscess, subdural empyema, meningitis, cavernous sinus thrombosis, epidural abscess, and osteomyelitis. The mechanisms and potential for intracranial spread of infection from the frontal, sphenoid, and ethmoid sinuses are discussed in detail. The management of each type of complication is outlined, including the use of computed tomography and magnetic resonance imaging, and the role of surgical drainage.
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