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. 2013 Aug;65(Suppl 2):431-4.
doi: 10.1007/s12070-013-0646-6. Epub 2013 Mar 24.

Clinical presentation and outcome of the orbital complications due to acute infective rhino sinusitis

Saroj Gupta  1 , Rashmi Goyal  2 , Rajendra Kumar Gupta  3
Affiliations

Clinical presentation and outcome of the orbital complications due to acute infective rhino sinusitis

Saroj Gupta et al. Indian J Otolaryngol Head Neck Surg. 2013 Aug.

Abstract

To describe the clinical presentation and visual outcome of patients with orbital complications of acute infective rhino sinusitis. This is a retrospective case series of patients diagnosed with of orbital involvement due to acute infective rhino sinusitis, who presented to eye OPD between July 2007 and July 2009. The medical records were reviewed with particular emphasis on clinical presentation and management. Twelve patients with an average age of 40.3 years (range, 14-65 years) were studied. The most common presentating symptom was diminution of vision (66.6 %) followed by proptosis, ptosis (33.3 %) and globe displacement (16.6 %). The most common orbital complication noted was orbital cellulitis (83.3 %). Majority of the patients had multiple sinus involvement. Ethmoid sinus was the most common sinus involved (91.6 %). Surgical intervention was required in 75 % of patients. Three patients (25 %) were managed conservatively by intravenous antibiotics. This series highlights the risk of orbital involvement and visual loss in patients with para nasal sinusitis. Early diagnosis, aggressive medical and prompt surgical treatment by multidisciplinary approach can successfully treat the complications.

Keywords: Acute rhino sinusitis; Orbital cellulitis; Paranasal sinuses; Visual loss.

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Figures

Fig. 1
Fig. 1
a Clinical photograph showing proptosis with periorbital and facial swelling on left side. b CT scan axial image showing opaque ethmoid sinus with signs of periorbital inflammation on left side. c Clinical photograph of the same patient after treatment
Fig. 2
Fig. 2
a CT scan coronal image showing opaque frontal ethmoid and maxillary sinuses on left side with bony destruction of floor and medial wall of orbit and inflammatory changes involving periorbital tissue. b Clinical photograph of the same patient showing cellulitis along lower eyelid. c Clinical photograph of the same patient after recovery
Fig. 3
Fig. 3
a Clinical photograph of the patient showing proptosis with lateral displacement of eye ball on right side. b CT scan orbit showing mucopyelocele of right frontal sinus displacing the eyeball downwards and outwards. c Clinical photograph of the same patient after surgery
See this image and copyright information in PMC

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