Pediatric sinogenic epidural and subdural empyema: The role of endoscopic sinus surgery.

摘要: Abstract Aim To analyze the indications and outcomes of open neurosurgical approaches (ONA) endoscopic transnasal (ETA) in surgical management pediatric sinogenic subdural epidural empyema. Material methods Retrospective single-center study design within a tertiary care referral center setting. Children less than 18 years age consecutively operated on between January 2012 February 2014 for drainage empyema (SE) or (EE) were included. Main outcome measures: success first procedure, persistent symptoms sequelae at end follow-up period. Results Nine SE (53%) 8 EE (47%) observed. Neurological symptoms, especially seizures, more frequent group. Perioperative pus samples positive 67% group 75% The most frequently isolated bacteria belonged to Streptococcus anginosus CT MR imaging showed that probably originated from frontal sinus. However, two cases resulted an ethmoiditis one case Pott's puffy tumor, without any direct contact with paranasal In SE, effective technique was ONA craniotomy. Associated sinus useful purpose bacteriological diagnosis. EE, effectiveness noted both ETA techniques. procedure encompassed through posterior wall (Draf III approach). number patients successfully treated after single higher (p = 0.05). Regarding outcomes, no mortalities Persistent disorders period, headaches, cognitive, concentration schooling problems, tended be (67% vs 29%), commonly observed requiring several procedures (75% 12.5%) Discussion Endoscopic surgery plays critical role EE. small volume approach associated antibiotherapy may sufficient treat infectious process.