Intracranial complications of sinogenic and otogenic infections in children: an ESPN survey on their occurrence in the pre-COVID and post-COVID era

• DOI: 10.1007/s00381-024-06332-9
• Publication Date: 2024-03-08T06:29:26Z
• Authors: L. Massimi; G. Cinalli; P. Frassanito; V. Arcangeli; C. Auer; V. Baro; A. Bartoli; F. Bianchi; S. Dietvorst; F. Di Rocco; P. Gallo; F. Giordano; J. Hinojosa; S. Iglesias; V. Jecko; G. Kahilogullari; F. Knerlich-Lukos...; R. Laera; D. Locatelli; D. Luglietto; M. Luzi; M. Messing-Jünger; R. Mura; P. Ragazzi; L. Riffaud; J. Roth; A. Sagarribay; M. Santos Pinheiro; P. Spazzapan; P. Spennato; N. Syrmos; G. Talamonti; L. Valentini; M. L. Van Veelen; M. Zucchelli; G. Tamburrini
• Keywords: Pandemic

Abstract Background COVID-19 pandemic is thought to have changed the epidemiology of some pediatric neurosurgical disease: among them are intracranial complications sinusitis and otitis (ICSO). According studies on a limited number cases, both streptococci-related ICSO would increased immediately after pandemic, although reason not clear yet (seasonal changes versus pandemic-related effects). The goal present survey European Society for Pediatric Neurosurgery (ESPN) was collect large cases from different countries encompassing pre-COVID (2017–2019), COVID (2020–2021), post-COVID period (2022–June 2023) looking possible epidemiological and/or clinical changes. Material methods An English language questionnaire sent ESPN members about year event, patient’s age gender, presence immune-deficit or other favoring risk factors, infection, signs symptoms at onset, site primary type complication, identified germ, surgical operations, duration medical treatment, radiological outcome, follow-up. Results Two hundred fifty-four were collected by 30 centers coming 14 countries. There statistically significant difference between (129 children, 86 cases/year, 50.7% whole series) (40 20 15.7%) (85 28.3 33.5%). Other differences concerned predisposing factors/concurrent diseases (higher in period) previous infection period). No relevant occurred as far demographic, microbiological, clinical, radiological, morbidity, mortality data concerned. Paranasal sinuses middle ear/mastoid most involved (71% 27%, respectively), while extradural subdural empyema brain abscess common (73% 17%, respectively). Surgery required 95% (neurosurgical ENT procedure 71% 62% respectively) antibiotics 99% cases. After 12.4-month follow-up, full recovery obtained 85% 84% respectively. rate 2.7%. Conclusions These results suggest that occurrence significantly pandemic. Such an increase seems be related indirect effects (e.g., immunity debt) rather than direct effect seasonal fluctuations. remain challenging but did affect management strategies nor their prognosis. change sinusitis/otitis should alert appropriate follow-up children with sinusitis/otitis.