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[Orbital and endocranial complications in acute sinusitis in childhood]
Insights
Acute sinusitis in children can lead to rare orbital complications. Early diagnosis with CT scans and surgical drainage, alongside antibiotics, significantly improves outcomes for these serious sinus infections.
Area of Science:
- Otolaryngology
- Pediatric Ophthalmology
- Infectious Diseases
Context:
- Acute paranasal sinusitis is common in children.
- Orbital complications are rare but serious.
- Antibiotics may mask early signs of complications.
Purpose:
- To report on the diagnosis and management of complicated sinusitis in pediatric patients.
- To highlight the role of CT scans in diagnosis and treatment planning.
- To evaluate the effectiveness of surgical intervention for orbital complications.
Summary:
- Eight pediatric patients with complicated frontal and ethmoid-maxillary sinusitis were treated.
- Cases included periorbital cellulitis, subperiorbital abscess, and orbital abscess with cavernous sinus thrombosis.
- CT scans were crucial for accurate diagnosis and guiding treatment.
- Most patients required surgical drainage in addition to antibiotics for rapid improvement.
Impact:
- Emphasizes the importance of vigilant diagnosis of sinusitis complications in children.
- Demonstrates the effectiveness of prompt surgical intervention for orbital abscesses.
- Highlights the diagnostic value of CT imaging in pediatric sinusitis complications.
Abstract:
Acute infection the paranasal sinus is a rather frequent pathology in children. On the contrary, local orbital complications are rare. The employment of antibiotics reduces the incidence of complications but can sometimes conceal their appearance so that diagnosis is delayed. Orbital as well as intracranial complications of ethmoidal and maxillary sinusitis are most often encountered in childhood. Within a brief time span, 8 patients with complicated frontal and ethmoid-maxillary sinusitis were diagnosed and treated: 4 cases of periorbital cellulitis, 2 of subperiorbital abscess and 2 of orbital abscess (one of which with cavernous sinus thrombosis). Particularly relevant from the diagnostic point of view was the employment of C.T. scan which furnished an accurate definition of the orbit and its surrounding structures which influenced treatment choice. Under antibiotic cover all patients but one (who had been treated very early and had responded immediately to intensive antibiotic therapy) were treated surgically and the clinical course of the disease showed significant improvement very shortly after surgical drainage.