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Published on: September 20, 2018
Radiographic Findings and Clinical Correlates in Pediatric Periorbital Infections
Jonathan M Grischkan1, Charles A Elmaraghy2, Matthew R Garrett3
1Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, Columbus, Ohio, USA.
Insights
In pediatric periorbital infections, lamina papyracea dehiscence was common and linked to increased surgical intervention needs. Sinonasal abnormalities were frequent but not directly correlated with surgery, except for lamina papyracea dehiscence.
Area of Science:
- Otolaryngology
- Pediatric Radiology
- Pediatric Infectious Diseases
Background:
- Periorbital infections in children can be serious, often linked to sinonasal issues.
- Understanding anatomical factors is crucial for managing these infections.
Purpose of the Study:
- To review radiographic findings in pediatric periorbital infections.
- To evaluate sinonasal anatomical factors and their relation to clinical outcomes.
Main Methods:
- Retrospective review of computed tomography (CT) scans in 100 pediatric patients with orbital infections.
- Analysis of sinonasal anatomical variants and Lund-Mackay scores.
- Chart review for treatment course and surgical intervention necessity.
Main Results:
- Lamina papyracea dehiscence was found in 21% of non-surgically treated patients and 76% of surgically treated patients (P=0.0048).
- Adenoid hypertrophy, inferior turbinate hypertrophy, and septal deviation were common but not statistically correlated with surgical need.
- Average Lund-Mackay score (11.8) did not correlate with surgical intervention.
Conclusions:
- This study highlights lamina papyracea dehiscence as a significant finding in pediatric periorbital infections.
- Lamina papyracea dehiscence is associated with a higher likelihood of requiring surgical intervention.
- Findings may influence the diagnosis, monitoring, and management of pediatric sinus disease.
Objective:
To review radiographic studies of pediatric patients presenting with periorbital infections and to evaluate sinonasal anatomical factors and clinical course related to this disease process.
Methods:
Retrospective study review of computed tomography (CT) scans in 100 patients less than 18 years old, admitted to a tertiary children's hospital with the diagnosis of an orbital infection. CT scans were reviewed for anatomic variants and Lund-Mackay scores were calculated. An independent chart reviews of the treatment course and need for surgical intervention was performed.
Results:
Of 100 patients, 67% were male, 60% had left-sided infections, and 30% of patients were treated with surgical drainage. Adenoid hypertrophy (61%), inferior turbinate hypertrophy (80%) and septal deviation (47%) were common, but did not show statistical correlation with the need for surgical intervention. Dehiscence of the lamina papyracea was identified in 21% of patients treated without surgery and in 76% of those requiring surgery (P 0.0048). The average overall Lund-Mackay score was 11.8 and did not correlate with the need for surgical intervention.
Conclusions:
To our knowledge, this is the first study to evaluate the incidence of sinonasal anatomic abnormalities in children presenting with periorbital infections. This study also demonstrated that lamina papyracea dehiscence is a common finding and is associated with higher rates of surgical intervention. Such findings may have an important role in the diagnosis, surveillance and management of sinus disease in the pediatric population.
