This study aims to analyze a series of cases admitted with intracranial empyema, either subdural or epidural, secondary to otorhinolaryngological (ENT) infections over a period of 10 years, including the COVID-19 pandemic. The incidence, characteristics, severity, and management of these conditions, as well as the influence of COVID-19, are described below.

The authors conducted a retrospective review of all of the children admitted to the Pediatric Neurosurgery Department of Nancy with intracranial empyemas secondary to a confirmed sinus (sinogenic) or mastoid (otogenic) infection between 2014 and 2024. They recorded their age, clinical presentation, initial Glasgow Coma Scale (GCS) score, bacteriological results, as well as the number and type of neurosurgical procedures they were subjected to, and their clinical outcome. These results were compared across two periods: before, and after the start of the COVID-19 pandemic.

Nineteen children in total were surgically treated, with twelve having a subdural location for their empyema, and seven located exclusively in the epidural compartment. The clinical presentation and evolution were positive in all except for one epidural empyema (6/7), and in the majority of the subdural locations (10/12). Twelve patients (63,16%) were treated after the start of the COVID pandemic, including 11 between 2022 and 2023. No differences were observed in patient characteristics, bacterial population and prognosis between these two periods. No patient was proven positive for COVID-19 at the time of their treatment.

Empyemas secondary to ENT infections are potentially serious pathologies, whose prognosis has clearly improved over the years. The incidence has significantly increased during the COVID-19 pandemic, without changing the characteristics or prognosis of the pathology. This increase mainly took place in the last 2 years of the pandemic in our department. The incidence remains even higher than before 2020.