Synopsis of key findings
The current study represents one of the largest cohort of children with sinogenic intracranial suppuration reported in the literature. The study findings confirm significant short and long-term morbidity previously described: 48.7% required revision surgery and 23.1% are left with neurological disability. The treatment course is complex and lengthy with most children requiring 3 weeks of inpatient treatment and a total of 6 weeks of antibiotic therapy. Majority of the patients were found to have either SDE (64%) or EDA (31%) with frontal sinus involvement observed in 85%. Consistent with the literature joint neurosurgical and sinus interventions were most frequently employed as an initial treatment approach (41%), however it was not found to result in improved outcomes. A significant proportion (38%) were managed with sinus interventions alone. The size of an intracranial abscess was the most important predictor for requiring revision surgery and patients were 7 times more likely to return to theatre if measured ≥10mm.