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[Orbital complications in acute and chronic sinusitis]
Beata Miaśkiewicz1, Marek Lukomski, Katarzyna Starska
1Instytut Fizjologii i Patologii Słuchu w Warszawie. beatamia@poczta.onet.pl
Polski Merkuriusz Lekarski : Organ Polskiego Towarzystwa Lekarskiego
|December 20, 2005
Summary
Orbital complications from sinusitis are rare but serious. Early diagnosis and treatment, often surgical, are crucial to prevent vision loss, with CT and MRI showing high accuracy in assessing bony structures.
Area of Science:
- Otolaryngology
- Ophthalmology
- Radiology
Background:
- Orbital complications from sinusitis are less common than previously thought.
- Chronic sinusitis can present with orbital and ocular symptoms like mucoceles and granulomas.
- Orbital and ocular symptoms include lid edema, proptosis, and orbital pain.
Purpose of the Study:
- To analyze symptoms, diagnostic procedures, and treatment options for orbital complications in sinusitis.
- To evaluate the diagnostic accuracy of CT and MRI in assessing orbital bony structures.
- To report outcomes of pharmacologic and surgical interventions.
Main Methods:
- Retrospective analysis of 33 patients with orbital complications.
- Review of presenting symptoms, diagnostic imaging (CT and MRI), and surgical findings.
- Categorization of treatment into pharmacologic and surgical approaches.
Main Results:
- Lid edema, proptosis, and orbital pain were the most frequent symptoms.
- CT and MRI demonstrated 80% correlation with intraoperative findings of the bony orbit.
- 13.3% of imaging assessments were false positives.
- Six patients received pharmacologic treatment; 27 underwent surgery.
- One case of blindness was reported.
Conclusions:
- Orbital complications of sinusitis, while rare, necessitate prompt evaluation and management.
- Imaging modalities like CT and MRI are valuable but not infallible in diagnosing bony orbital involvement.
- Surgical intervention is frequently required for effective treatment of these complications.