Attempt to isolate indication-giving patient parameters for NNH surgery in acute meningitis

Introduction:

Meningitis is a disease associated with severe consequences and, in the case of septic disease, with a 10% mortality. In parameningeal foci of infection (sinusitis, mastoiditis), it is difficult to distinguish between coincidence or causal significance, and the status of shaded nasal sinuses on CT (NNH) is often unclear. For this reason, we asked ourselves whether we should be able to isolate clinical parameters from our patient population, which can help in the indication of an NNH operation in the context of meningitis.

Material and methods:

Retrospectively, the ENT clinic population of the last 10 years was examined with regard to the coincidence of meningitis and NNH surgery.

Results:

21 patients with meningitis and signs of sinusitis on CT could be identified (10 ♂/11 ♀). Common initial symptoms were cephalgia (76%), fever (71%), somnolence (52%), neck stiffness (42%). All patients had leukocytosis and CRP elevation. In 68% of the cases an isolated NNH was observed on CT (S. sphenoidales -30%, S. maxillaris 28%, S. frontalis 10%). All patients underwent endonasal-endoscopic surgery. A correlation of the CT data with the intraoperative findings with regard to acute sinusitis was not found. 2 patients died. The median length of hospital stay was 19.90 ± 4.8 for men and 37.45 ± 21.4 days for women.

Conclusion:

The indication for NNH surgery in the context of meningitis in the presence of shading remains unclear and is likely to be determined only in prospective studies.

Publication History

Publication Date:
23 April 2019 (online)