Neurosurgery for sinusitis-related and sinusitis-unrelated intracranial abscess

Abstract

Background: Sinusitis-related intracranial abscess (ICA) is a rare but serious complication and is different from those of sinusitis-unrelated ICA. Purpose: This study aimed to analyze the differences in bacteriology, host factors, presentations, and prognoses between cases of sinusitis-related and sinusitis-unrelated ICA. Methods: This retrospective study was conducted at Buddhist Tzu Chi General Hospital (Hualien, Taiwan), during January 2010–August 2014, and enrolled patients with pathologically proven postsurgery ICA. P < 0.05 was considered statistically significant. Results: The number of patients with sinusitis-related and sinusitis-unrelated ICA was 10 and 17, respectively. Compared with sinusitis-unrelated ICA patients, significantly more patients with sinusitis-related ICA experienced cirrhosis, ophthalmic abnormalities, and frontal and cavernous sinus involvement. Among all ICA patients, diabetes mellitus (DM) was associated with an increased mortality risk. Patients with DM exhibited the highest positive culture rates for Klebsiella pneumoniae. Conclusion: Frontal sinusitis is associated with an increased risk of intracranial invasion. DM and liver cirrhosis patients exhibited the highest mortality rates among all ICA patients. Patient comorbidity should be considered when prescribing antibiotics for treatment.

Keywords

• Intracranial abscess
• neurosurgery
• sinusitis