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[Endoscopic treatment of orbital cellulitis in pediatric patients: transethmoidal approach]
M Cavaliere1, F Volino, G Parente
1Departamento de Otorrinolaringología, Hospital Universitario San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italia. matorl@inwind.it
Insights
Orbital cellulitis in children, often linked to acute ethmoiditis, frequently requires endoscopic drainage for effective treatment. This surgical approach ensures rapid recovery with minimal discomfort and complications.
Area of Science:
- Ophthalmology
- Pediatric Otolaryngology
Context:
- Orbital cellulitis is a common pediatric condition, frequently associated with acute ethmoiditis.
- It presents as a septic process affecting orbital soft tissues, leading to unilateral exophthalmos.
Purpose:
- To evaluate the efficacy of endoscopic transethmoidal drainage for pediatric orbital cellulitis (Chandler stage II-IV).
- To assess the role of adenoidectomy in managing associated lymphatic organ infections.
Summary:
- Thirty-six pediatric patients with orbital cellulitis (Chandler stage II-IV) were treated between 2001-2010.
- Medical management resolved 6 cases; 30 required endoscopic drainage via the transethmoidal route due to lack of improvement.
- Adenoidectomy was performed in pediatric cases to address potential lymphatic infections.
Impact:
- Endoscopic drainage led to rapid disease resolution without complications.
- The procedure resulted in minimal postoperative discomfort and a swift return to daily activities for pediatric patients.
Abstract:
Orbital cellulitis is a septic process of the soft tissues behind the orbital septum and is the most frequent cause of the monolateral exophthalmos in pediatrics. Approximately 90% of the orbital cellulitis in pediatrics are associated to acute ethmoiditis. From the 01.01.2001 to 31.12.2010 we treated 36 patients, less than 18 years-old affected by Chandler stage II, III, or IV orbital cellulitis. The inflammation was resolved medically in 6 patients. In the 30 cases that showed no improvement in 48-72 h, an endoscopic drainage of the pus was performed by the transethmoidal route. In children, an adenoidectomy should be included, in order to eliminate eventual infections of this lymphatic organ. Endoscopic treatment has resulted in rapid resolution of disease without any complications. In addition, postoperative discomfort is minimal, with a rapid return to daily activities.
