Polyvinyl Alcohol Nasal Pack as a Rare Cause of Brain Abscess Following Endoscopic Sinus Surgery

Vollständiger Abstract

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Abstract Brain abscesses are rare but severe infections that often require surgical intervention and prolonged antibiotic therapy. Development of a brain abscess following endoscopic sinus surgery (ESS) for nasal polyposis is extremely rare. We report the case of a 52-year-old female with a history of multiple endoscopic surgeries for nasal polyposis. She presented with symptoms of headache and fever for 20 days, following revision ESS performed a month earlier. Imaging revealed a right frontal lobe abscess with an associated foreign body, later identified intraoperatively as a polyvinyl alcohol (PVA) nasal pack that had migrated intracranially through a skull base defect. The abscess was drained surgically, and the PVA pack was removed. The patient received a prolonged course of intravenous antibiotics with full clinical recovery. To the best of our knowledge, this is the first reported case of a brain abscess secondary to intracranial migration of a PVA nasal pack following ESS. This case highlights the critical importance of meticulous nasal cavity packing and skull base assessment during and after ESS, especially in revision cases.