دورية أكاديمية
Efficacy of endoscopic sinus surgery alone versus in combination with neurosurgical intervention for the treatment of pediatric subdural empyema.
| العنوان: | Efficacy of endoscopic sinus surgery alone versus in combination with neurosurgical intervention for the treatment of pediatric subdural empyema. |
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| المؤلفون: | Gillard DM; Department of Otolaryngology- Head and Neck Surgery, University of California San Francisco, San Francisco CA, USA. Electronic address: danielle.gillard@ucsf.edu., Cai Y; Department of Otolaryngology- Head and Neck Surgery, University of California San Francisco, San Francisco CA, USA., Rothey PK; Department of Radiology, University of California San Francisco, San Francisco, CA, USA., Coleman N; Department of General Surgery, University of Arizona, Tuscon, AZ, USA., Virbalas JM; Department of Otolaryngology- Head and Neck Surgery, University of California San Francisco, San Francisco CA, USA., Czechowicz JA; Department of Otolaryngology- Head and Neck Surgery, University of California San Francisco, San Francisco CA, USA., Weinstein JE; Department of Otolaryngology- Head and Neck Surgery, University of California San Francisco, San Francisco CA, USA. |
| المصدر: | International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2021 Sep; Vol. 148, pp. 110836. Date of Electronic Publication: 2021 Jul 12. |
| نوع المنشور: | Journal Article |
| اللغة: | English |
| بيانات الدورية: | Publisher: Elsevier Scientific Publishers Country of Publication: Ireland NLM ID: 8003603 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1872-8464 (Electronic) Linking ISSN: 01655876 NLM ISO Abbreviation: Int J Pediatr Otorhinolaryngol Subsets: MEDLINE |
| أسماء مطبوعة: | Publication: Limerick : Elsevier Scientific Publishers Original Publication: [Amsterdam] Elsevier/North-Holland. |
| مواضيع طبية MeSH: | Empyema, Subdural*/diagnosis , Empyema, Subdural*/surgery, Child ; Craniotomy ; Endoscopy ; Humans ; Neurosurgical Procedures ; Retrospective Studies |
| مستخلص: | Objectives: To compare treatment outcomes for sinogenic subdural empyema (SE) between those managed with initial endoscopic sinus surgery (ESS) alone versus those treated with a combination of ESS and craniotomy over the last decade at our institution. To better characterize subdural empyema with regard to presentation, causative pathogens, and treatment course. Methods: Retrospective single-center chart review to identify and evaluate pediatric SE patients between 2009 and 2019. Patients meeting inclusion criteria were classified in one of two groups: those who initially underwent ESS or frontal trephination without concurrent neurosurgical procedure and those who underwent craniotomy or burr hole in addition to a sinus procedure. Presenting characteristics and treatment outcomes were compared between the two groups. Results: Eighteen patients met inclusion criteria. The ESS alone and the ESS + craniotomy subgroups each had 9 patients with similar baseline characteristics. The ESS + craniotomy group was more likely to present with neurological symptoms (p = 0.039) and have multiple intracranial fluid collections (p = 0.046). 74.1% of patients presented to the Emergency Department (ED) or to their primary medical doctor and were treated with outpatient management prior to hospitalization with definitive surgical management. The most common presenting symptoms were fever, headache and nausea/vomiting. There were no differences between treatment groups in rate of return to the operating room (OR) (p = 1.00), length of stay (LOS) (p = 0.553), or adverse neurological outcomes (p = 0.456). 44.4% of patients in the ESS alone group eventually required neurosurgical intervention. Conclusions: Surgical SE patients often present to medical professionals in the primary care setting or ED and are managed with outpatient treatment before admission with definitive treatment. In this small retrospective cohort patients who underwent sinus intervention alone had similar rates of return to OR, LOS and adverse neurological outcomes use as those who underwent a sinus procedure in coordination with a neurosurgical intervention. There may be a group of patients with SE who may be managed with endoscopic procedures alone and further studies should seek to determine the characteristics of this population. (Copyright © 2021 Elsevier B.V. All rights reserved.) |
| فهرسة مساهمة: | Keywords: Craniotomy; Endoscopic sinus surgery; Subdural empyema; Surgical outcome |
| تواريخ الأحداث: | Date Created: 20210716 Date Completed: 20210818 Latest Revision: 20210818 |
| رمز التحديث: | 20240628 |
| DOI: | 10.1016/j.ijporl.2021.110836 |
| PMID: | 34271525 |
| قاعدة البيانات: | MEDLINE |
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Full Text Finder | تدمد: | 1872-8464 |
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| DOI: | 10.1016/j.ijporl.2021.110836 |