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. 2016 Jul;33(4):401-6.
doi: 10.5152/balkanmedj.2016.141065. Epub 2016 Jul 1.

Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

Yuzhu Wan  1 , Guanggang Shi  1 , Haibo Wang  1
Affiliations

Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

Yuzhu Wan et al. Balkan Med J. 2016 Jul.

Abstract

Background: The orbital complications account for about 80% of all complications secondary to acute rhinosinusitis. If the treatment is not correct and in time, orbital complications could progress rapidly, leading to optic neuritis, cavernous sinus thrombophlebitis or life-threatening intracranial complications.

Aims: To evaluate the therapeutic efficacy of conservative therapy for the patients with orbital cellulitis and endoscopic sinus surgery (ESS) performed on patients with subperiosteal abscess (SPA) secondary to acute rhinosinusitis in children.

Study design: Retrospective cross-sectional study.

Methods: The retrospective study included 31 pediatric patients with orbital complications secondary to acute rhinosinusitis. In all cases, intensive treatment was initiated with a combination of oral or intravenous antibiotics, glucocorticoid and gelomyrtol forte after admission. ESS was performed if an improvement in the condition of patients did not occur after 48 hours. However, the patients with orbital SPA, motility disorders of eyeball or decreased vision received ESS immediately within 24 hours.

Results: Sixteen patients were cured by conservative therapy and 15 patients by ESS. All of the signs and symptoms disappeared after conservative therapy or ESS. There were no recurrences within the follow-up period of 1 to 8 years.

Conclusion: Conservative therapy is an effective method for patients with inflammatory edema and most cases of orbital cellulitis in children. SPA can be cured by ESS.

Keywords: Acute rhinosinusitis; orbital cellulitis; orbital complication; subperiosteal abscess; surgical drainage.

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Figures

FIG. 1.
FIG. 1.
Indicating left eyelid edema and proptosis (Case 5)
FIG. 2.
FIG. 2.
Arrow indicating SPA located in the left orbit (Case 5)
FIG. 3.
FIG. 3.
Arrow indicating the small defect in the lamina papyracea removed by ESS (Case 1)
FIG. 4.
FIG. 4.
MRI scan of two SPAs (Case 2), Arrow indicating two SPAs located in the medial and superior orbit
See this image and copyright information in PMC

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