Speech disorder in the context of an acute frontal sinusitis

The anatomical proximity of the paranasal sinuses to the brain and orbit explains the occurrence of severe and life-threatening inflammatory complications in sinusitis, which persist even today. While these severe cases are relatively rare overall, they should be recognized and treated promptly due to their lethality ranging from 10 to 20%, often resulting in functional impairments such as epileptic seizures and nerve palsies [1] [2]. A 36-year-old female patient presented with acute sinus complaints and accompanying stuttering. The unclear stuttering observed upon admission was neurologically assessed, and a cranial CT scan was performed, revealing no evidence of neurological correlates but extensive mucosal swelling in the bilateral ethmoid sinuses with involvement extending into the bilateral frontal sinuses. Despite antibiotic and local nasal therapy, there was no improvement in symptoms. Following neurological consultation and an unremarkable lumbar puncture, reactive meningeal irritation was considered as the cause, associated with pronounced frontal sinusitis. Subsequently, a sinus clearance procedure was carried out. After the operation, a rapid improvement in the stuttering was observed, leading to discharge after 10 days. Intracranial complications most commonly originate from the frontal sinus [2]. In addition to the consequences of increased intracranial pressure, local brain symptoms may arise due to meningeal irritation (e.g., motor aphasia resulting from irritation or potential damage to the Broca's speech center) [2]. The primary focus is always on the surgical clearance of the affected paranasal sinuses along with antibiotic therapy [1] [2] [3].

• Literatur

• 1 Iro H., Wurm J., Zenk J.. Komplikationen bei entzündlichen Erkrankungen der Nasennebenhöhlen.
• 2 Berghaus A, Rettinger G, Böhme G. Duale Reihe Hals-Nasen-Ohren- Heilkunde 6.5.3.
• 3 Reiß M. Facharztwissen HNO-Heilkunde, 5.5

Publication History

Article published online:
19 April 2024