• Jonathan S Glickstein, Rakesh K Chandra, and Jerome W Thompson.
• University of Tennessee Health Science Center, Department of Otolaryngology-Head and Neck Surgery, 956 Court Ave Suite B224, Memphis, TN 38163, USA. jglickstein@utmem.edu
• Otolaryngol Head Neck Surg. 2006 May 1; 134 (5): 733-6.

ObjectiveTo study intracranial extension of pediatric sinusitis, an infrequent but potentially fatal complication.Study Design And SettingTen-year retrospective review at a tertiary children's hospital identified 21 cases of intracranial complications of sinusitis.ResultsThirteen males and eight females with mean age of 13.3 years were identified. Overall 18 of 21 (81%) exhibited abscess formation, most commonly epidural. Only 3 of 21 (14%) had meningitis alone. All but 4 patients were managed surgically, requiring craniotomy in 13 of 21 (61.9%) and endoscopic sinus surgery (ESS) in 10 of 21 (48%). Seven patients (33%) required multiple operations during admission. Nineteen patients (90%) had a total of 30 organisms cultured. Oral flora was observed in 12 of 21 (57%). Polymicrobial infections, seen in 9 of 21 (43%), were significantly associated with the need for craniotomy (P=0.02). Mean hospital stay was 15 days, and mean length of IV antibiotic was 5 weeks.ConclusionsIntracranial complications of pediatric sinusitis often require craniotomy. Oral flora and polymicrobial infections were prominent in this series.Ebm RatingC-4.

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