AI Article Synopsis
- Recent studies indicate that an endoscopic endonasal approach for accessing the middle fossa is feasible, though there have been few clinical applications reported.
- A case involving an 8-year-old boy with a middle fossa epidural abscess linked to sphenoid sinusitis was successfully treated using this method, leading to complete drainage and significant symptom relief.
- The procedure highlighted the importance of the maxillary strut in enabling access to the middle fossa, suggesting this approach could be beneficial for similar cases in the future.
Article Abstract
Background: Recent anatomical studies have reported the feasibility of the endoscopic endonasal approach to the middle fossa. However, its clinical applicability has been discussed in only a few cases. This article describes the case of a middle fossa epidural abscess successfully drained through a fully endoscopic endonasal corridor and discusses the key technical points.
Observations: The authors describe an 8-year-old boy who presented with worsening headache, fatigue, emesis, and fever and was diagnosed with a left middle fossa epidural abscess associated with sphenoid sinusitis. Following endoscopic sinus surgery performed by a rhinologist, the middle fossa was accessed by removing the maxillary strut through the transmaxillary transpterygoid corridor. Complete drainage of the abscess was confirmed on postoperative magnetic resonance imaging. The patient tolerated the surgery without neurological deficit and demonstrated prompt symptom improvement. He was discharged home after completing a 6-week course of antibiotic therapy and remained free from recurrence at 1 year following surgery.
Lessons: The endoscopic endonasal approach may be applicable to a middle fossa epidural abscess, resulting in prompt clinical improvement. The maxillary strut is a key structure for entering the middle fossa. https://thejns.org/doi/10.3171/CASE24288.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11323852 | PMC |
| http://dx.doi.org/10.3171/CASE24288 | DOI Listing |
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