Prognostic factors of paranasal sinusitis with intracranial invasion: A 14-year review of cases at Hualien Buddhist Tzu Chi Hospital

Kuan-Pin Chen^a, Yu-Cheng Chou^a, Chia-Fone Lee^b, Tomor Harnod^a, Shin-Yuan Chen^a, Chain-Fa Su^a, Peir-Rong Chen^b, Tsung-Lang Chou^a

^a Department of Neurosurgery, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan
^b Department of Otorhinolaryngology, Buddhist Tzu Chi General Hospital and Tzu Chi University, Hualien, Taiwan

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Open Access funded by Buddhist Compassion Relief Tzu Chi Foundation

Abstract

Intracranial invasion of paranasal sinusitis is an emergency condition that requires surgical and medical intervention in order to avoid further deterioration. We surveyed patients at the Buddhist Tzu Chi Hospital (Hualien, Taiwan) who had paranasal sinusitis with intracranial invasion. A total of 505 patients with paranasal sinusitis were surveyed at Hualien Buddhist Tzu Chi Hospital over a 14-year period (2000–2013). Data on clinical presentations, microbiology, host factors, postinterventional morbidity, and postinterventional mortality are presented. Of the 505 patients, nine had intracranial invasions (incidence rate, 1.8%). The mortality rate was high among these patients (44.4%, 4/9). Among the various risk factors identified, diabetes had the greatest influence (66.7%, 6/9), which in combination with an immunocompromised condition and cirrhosis is indicative of a poor prognosis.

Keywords

Brain abscess; Encephalitis; Paranasal sinusitis; Subdural empyema; Ventriculitis