Orbital and intracranial complications of common infections of the head and neck Current insights and changing views

In this thesis we evaluate the current diagnostic and treatment strategies and disease outcomes of orbital and cranial complications of common infections in the head and neck area (HNA).
The clinical presentation of orbital cellulitis, cavernous sinus thrombosis and superior ophthalmic vein thrombosis can be similar. To establish the right diagnosis and therapy, (contrast enhanced) imaging is required. For orbital cellulitis, distinction should be made between diffuse orbital infiltration, subperiosteal empyema and orbital abscess. The clinical presentation of patients with otogenic intracranial complications may differ between children and adults. Children more often show symptoms similar with meningitis, whereas adults more frequently present with decreased consciousness and/or hemiparesis.
Treatment of orbital and intracranial complications has shifted from radical/invasive towards minimal invasive over the last decades. We show that orbital cellulitis can be managed with antibiotic treatment in many cases. Furthermore, in our series about Pott's puffy tumour, we show that an endoscopic endonasal approach is a safe and viable option.
Patients with intracranial thrombosis due to HNA infections should be treated with anticoagulants (in the absence of contraindications).
The prognosis of orbital and intracranial complications of HNA infections is nowadays favorable . Nonetheless, people still die from these complications, also in our series. Therefore, early recognition, adequate imaging and multidisciplinary treatment remains important.