Main outcomes
Regarding the total cohort, 19/39 (48.7%) needed to return to theatre for another surgery after initial treatment. Furthermore, 9/39 (23.1%) of patients had ND at 6 months and 3/39 (7.7%) died within 90 days of admission. The rate of re-admission related to sinogenic intracranial infection was 3/39 (7.7%). Mean length of hospital stay was 20 (SD 19) days. Overall, all outcomes except for ND were comparable across the four treatment approaches (table 5). The risk of ND was significantly higher (p=0.033) in patients treated with neurosurgery alone (3/4, 75%) compared to those treated with ENT intervention alone (1/15, 6.7%).
Six of 15 (40%) patients initially treated with sinus only interventions required further neurosurgical interventions, while 10/16 (62.5%) required revision neurosurgical drainage in the combined treatment group. Three out of 4 patients were successfully treated with intravenous antibiotics without requiring surgical intervention. Median time for revision surgery was 5 days (interquartile range 20).