OBJECTIVETo explore the causes, clinical manifestation and therapy of frontal sinusitis after transfrontal craniotomy.

METHODSThirty-three patients with frontal sinusitis after transfrontal craniotomy were included in the study. Among them, 7 cases had frontal sinus abscess and 4 cases had frontal sinus fistula. Twenty-three patients were treated with traditional frontal sinus surgery with facial incision. The nasofrontal dilatation tube was positioned for more than 3 months. Nine patients were treated with endoscopic frontal sinus surgery, and 1 patient was treated with combined endoscopic and traditional frontal sinus surgery, with nasofrontal dilatation tube positioned for less then 1 month. In the revision surgery, the bone wax and phlogistic acestoma were cleaned out in both operational methods. The causes of frontal sinusitis after transfrontal craniotomy were discussed by studying the frontal sinus CT image, and prior surgical data.

RESULTSAll patients were followed up for more than 6 months after the nasofrontal dilatational tube was removed. Among 33 patients, two cases with traditional frontal sinus surgery were operated twice due to nasofrontal dilatation tube fall off in 1 month. In all 33 patients, 30 cases cured and 3 cases got better. There were no curative difference between two operational methods.

CONCLUSIONSThe causes of frontal sinusitis after transfrontal craniotomy were inadequate sinus management in craniotomy and bone wax tamping in frontal sinus. There was more frontal sinus abscess and fistula occurring in frontal sinusitis after transfrontal craniotomy than that in ordinary frontal sinusitis. The therapy included cleaning out bone wax and phlogistic acestoma, and expanding the frontal sinus ostium. The satisfying curative effect was obtained in both operational methods, but endoscopic frontal sinus surgery was better because it is minimally invasive, no facial incision and quick recovery with less nasofrontal dilatational tube posting time.

Adult ; Craniotomy ; adverse effects ; Female ; Forehead ; surgery ; Frontal Sinusitis ; etiology ; therapy ; Humans ; Male ; Middle Aged ; Postoperative Complications ; therapy

Objective:To explore the characteristics and therapeutic strategies of Pott's puffy tumor（PPT）. Methods:The clinical data of two patients with PPT were retrospectively analyzed and combined with the literature, focusing on the comprehensive analysis of perioperative diagnosis and treatment strategies. Both patients underwent muti-disciplinary treatment, including timely administration of sufficient antibiotics capable of penetrating the blood-brain barrier. Early removal of PPT lesions was performed using a combined internal and external approach under nasal endoscopic guidance. Results:After standardized perioperative management, the symptoms of the two patients were completely relieved, with no recurrence after one=year follow=up. Postoperative complications such as frontal pain, numbness, local depression, or scar hyperplasiawere not present. Conclusion:PPT, being relatively rare and severe, requires careful attention. Key strategies for standardized perioperative management include multi-disciplinary consultation, timely and adequate antibiotic administration, and surgical intervention using a combined intranasal and extranasal endoscopic approach for lesion removal.
Humans ; Pott Puffy Tumor/complications* ; Retrospective Studies ; Tomography, X-Ray Computed ; Endoscopy/adverse effects* ; Postoperative Complications ; Anti-Bacterial Agents/therapeutic use* ; Frontal Sinusitis/complications*

OBJECTIVETrying to find a useful marker to subclassify chronic rhinosinusitis (CRS), ratio of eosinophil in peripheral blood was investigated.

METHODSHistologic characteristics of surgical samples were analyzed in 119 CRS with nasal polyps (CRSwNP) patients, who were classified into eosinophil CRSwNP (ECRSwNP) group and non-ECRSwNP group. Peripheral blood eosinophil percentage, olfactory function, skin prick test, serum total IgE and sinus CT scan in two groups were all examined and analyzed. To evaluate the discriminatory power of eosinophil to diagnose ECRSwNP, the Receiver Operating Characteristic(ROC)curve was analysed.

RESULTSThere were significant differences in Ratio of EOS, serum total IgE, and olfactory function scores, between ECRSwNP group and non-ECRSwNP group(mean value were 7.31%: 3.90%, 60.9 IU/L: 28.9 IU/L, 5.8: 0.4 respectively, U value were 620.01, 1020.53 and 1092.52, respectively, all P < 0.05). However, there was no difference in skin prick test between two groups. In CT scan exam, there were no differences in Lund-Mackay scores in frontal sinus, anterior ethmoid sinus, posterior ethmoid sinus, sphenoid sinus and ostiomeatal complex area, but maxillary sinus, between ECRSwNP group and non-ECRSwNP group (U value were 27.5, 23.5, 22.5, 31.5, 28.5, respectively, all P > 0.05, and U value of maxillary sinus was 12.01, P < 0.05 ). Peripheral blood eosinophil percentage and serum total IgE were related with pathology of nasal polyps (r value were 0.55, 0.24, and P value were 0.001, 0.01, respectively), especially blood eosinophilia can be a predictor of ECRSwNP. The area under curve was 0.818 and cutoff value was 5.65%.

CONCLUSIONSECRSwNP is different from non-ECRSwNP in many clinical features. Peripheral blood eosinophil percentage is consistent with histologic features of ECRS, which is a useful marker as 5.65% in classification of CRS.

Chronic Disease ; Eosinophils ; Ethmoid Sinus ; Frontal Sinus ; Humans ; Leukocyte Count ; Maxillary Sinus ; Nasal Polyps ; complications ; Paranasal Sinuses ; ROC Curve ; Rhinitis ; complications ; physiopathology ; Sinusitis ; complications ; physiopathology ; Skin Tests ; Tomography, X-Ray Computed