Our Experience of Surgically Managing Orbital Complications Due to Chronic Sinusitis: A Case Series

Abstract

Despite antibiotic treatment applied in Otorhinolaryngology, orbital complications due to chronic rhinosinusitis are considered a threat to the functions of the eyes. If timely intervention is not provided, orbital complications could rapidly progress to optic neuritis or life-threatening intracranial complications. A retrospective study included four patients between the ages of 29-70 years with orbital complications due to chronic sinusitis. Diagnosis was based on history, clinical examination, and imaging. In all cases, treatment was initiated with intravenous antibiotics and steroids. Surgical intervention was performed in all the patients when symptoms failed to resolve after 48 h of intravenous treatment. In our study, we encountered patients with orbital complications which included pre-septal cellulitis (75%) and frontal sinus fistula (25%). Average time of hospital stay was 9.5 days. All patients underwent surgery after 48 h of intravenous treatment and showed resolution of orbital symptoms within 2-6 months post-operatively. No recurrences have been encountered till date. Orbital complications are severe pathologies which require immediate attention and aggressive treatment via endoscopic approach as well as antimicrobial treatment to prevent unwanted threat to life.

Keywords: Chronic sinusitis; Endoscopic sinus surgery; Frontal sinus; Orbital complications.

Fig. 1

Patient with frontal sinus fistula who underwent frontal sinusotomy with infant feeding tube

Fig. 2

CT scan of the patient with left frontal sinus fistula (A—Axial view, B—Coronal view)