Intraorbital and Intracranial Complications of Acute Rhinosinusitis: A Rare Case Report

Document Type : Case Report

Authors

Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar ,Odisha ,India Pin-751019.

Abstract

Introduction:
Complications of acute sinusitis affecting multiple sites are very uncommon in the antibiotic era. However, a significant proportion of patients (5–40%) suffering from acute sinusitis can have these complications mostly due to the delayed diagnosis of the disease. Patients can have variable presentations according to the site and extent of the infection.
 
Case Report:
A 21-year-old male student presented with subperiosteal abscess and a brain abscess with a history of acute sinusitis. The patient had short history of left-side hemiplegia with foot drop. Endoscopic orbital decompression was performed and the subperiosteal abscess was drained when it did not respond to medical treatment. Complete clinical and radiological recovery was achieved after 1 month of medical treatment.
 
Conclusion:
Complications affecting the multiple sites in acute sinusitis is very uncommon in the antibiotic era.
A proper history and thorough clinical examination along with a radiological evaluation are key factors in the final diagnosis of the patients with suspected complications. A quick multidisciplinary approach among otorhinologsts, ophthalmologists and general physicians is always necessary to avoid unwanted life-threatening complications.

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1. Sow AJ, Jahendran J, Toh CJ, Kew TY. Sphenoethmoid sinusitis in a child resulting in a disastrous intracranial sequela. Ear, Nose and Throat Journal. 2012;91(11): E20-2.
2. Ketenci İ, Ünlü Y, Vural A, Dogan H, Sahin MI, Tuncer E. Ap­proaches to subperiosteal orbital abscesses. Eur Arch Otorhino­laryngol 2013; 270: 1317–27.
3. Jones NS, Walker JL, Bassi S, Jones T, Punt J. The intracranial complications of rhinosinusitis: can they be prevented?  Laryngoscope.  2002;112:59-63.
4. Giannoni CM, Stewart MG, Alford EL. Intracranial complications of sinusitis.  Laryngoscope. 1997;107:863–7.
5. Kayhan FT, Sayin I, Yazici ZM, Erdur O. Management of or­bital subperiosteal abscess. J Craniofac Surg 2010;21:1114–7.
6. Younis RT, Lazar RH, Anand VK. Intracranial complications of sinusitis: a 15-year review of 39 cases. Ear Nose Throat J 2002;81:636–8, 640-2, 644.
7.  Adnan SB. Instructive case. A swollen eye. J Paediatr Child Health. 2000;36:179–181.
8.  Rosen D, Ardekian L, Abu El-Naaj I, et al. Orbital infection arising from a primary tooth: a case report. Int J Paediatr Dent. 2000;10:237–239.
9. Clayman GL, Adams GL, Paugh DR, et al. Intracranial complications of paranasal sinusitis: a combined institutional review. Laryngoscope. 1991;101:234-9.
10.  Singh B. The management of sinogenic orbital complications. J Laryngol Otol.  1995; 109: 300–3.
11.  Lu CH, Chang WN, Lui CC. Strategies for the management of bacterial brain abscess. J Clin Neurosci. 2006;13:979–85.
12.  Brown CL, Graham SM, Griffin MC, Smith RJ, Carter KD, Nerad JA, et al. Pediatric medial subperiosteal orbital abscess: medical management where possible. Amer J Rhinol. 2004;18:321–7.