Related Experiment Video
Updated: Jan 3, 2026
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Orbital complication of acute ethmoiditis: A Tunisian paediatric cross sectional study
Asma Ben Mabrouk1, Selmen Wannes2, Mehdi Hasnaoui3
1University Hospital Thar Sfar, Mahdia Pediatric Department, 5100 Mahdia, Tunisia.
Insights
Acute ethmoiditis in children frequently causes orbital complications. Imaging like CT scans is crucial for timely detection and treatment adaptation, as clinical signs do not predict severity.
Area of Science:
- Otolaryngology
- Pediatric Ophthalmology
- Pediatric Infectious Diseases
Background:
- Acute ethmoiditis is the earliest sinusitis form in children due to sinus anatomy.
- Orbital complications are common and can lead to severe visual and neurological impairment.
Purpose of the Study:
- Investigate clinical, biological, and radiological features of orbital complications from acute ethmoiditis.
- Identify predictive factors for severe ophthalmological and/or cerebral complications.
Main Methods:
- Cross-sectional study of pediatric patients with orbital extension of acute ethmoiditis over 14 years.
- Classification of orbital and cerebral CT scans using Chandler's criteria for lesion severity.
Main Results:
- 41% complication rate in 39 ethmoiditis cases; 16 patients included.
- Orbital extension stages varied, with two cases having intracranial extension.
- No clinical or biological factors (fever, exophthalmos, CRP, WBC) predicted CT-scan severity.
Conclusions:
- Orbital complications of ethmoiditis are frequent in children.
- Predicting severity based on clinical or biological data is unreliable.
- CT scans are vital for early detection and guiding antibiotic or surgical treatment.
Objective:
The anatomical and developmental particularities of sinus cavities in paediatric population lead acute ethmoiditis to be the earliest form of sinusitis in children. Orbital complications are frequent and could lead to visual and neurological impairment. This study investigated the clinical, biological and radiological features of orbital complications. We identified the predictive factors of severe ophthalmological lesions and/or associated cerebral complications of acute ethmoiditis.
Design And Methods:
This cross sectional study included all patients identified as having orbital extension of acute ethmoiditis in the database of a single academic paediatric care centre over a period of 14 years. All orbital and cerebral Scans of the included patients were reviewed and the cohort was classified using Chandler's classification as having less severe lesions (Chandler's 1 and 2) or more serious lesions (Chandler's 3, 4 and 5).
Results:
In total, 16 patients (12 girls and 4 boys) were included among 39 consecutives cases of ethmoiditis recessed with a complication rate of 41%. Average consultation delay was 4.88 days. The mean age was 4.37 years. Fever was objectified in 13 cases (81%). Six patients (37.5%) had exophthalmos. Orbital extension spectrum was: stage I (n = 4, 25%), stage II (n = 4, 25%), stage III (n = 6, 37.5%), stage IV (n = 1, 6.5%), stage V (n = 1, 6.5%) and intra cranial extension was associated in two cases. Univariate analysis showed that fever, exophthalmos, ophthalmoplegia, positive CRP, age and white blood cells count were not associated with more severe lesions in the CT scan. Initially, all children received intravenous antibiotic treatment. Association of multiple antibiotics was prescribed in 75% of the cases. With 21.07 days ± 5.51 days as a total treatment duration. Only Four patients underwent surgical treatment.
Conclusion:
Orbital complications of ethmoiditis are frequent. No clinical or biological criteria seem to predict the severity of orbital lesions. Both orbital and brain CT scan could help detect eventual complications on time to adapt antibiotic treatment and eventually bring forward surgical intervention.
Related Concept Videos
01:30Tonsillitis I: Introduction
Etiology
Three primary contributing factors have been identified.
01:26Tonsillitis II: Management
01:30Acute Pharyngitis
Acute pharyngitis is the inflammation of the back of the throat (pharynx), commonly resulting in a sore throat. It is a frequently encountered condition that prompts individuals to seek medical advice.
Classification
Acute pharyngitis can be categorized based on its underlying cause:
01:27Cranial Bones: Lateral View
The temporal bone forms the lower lateral side of the skull. The temporal bone is subdivided into several regions. The flattened upper portion is the squamous portion of the temporal bone. Below this area and projecting anteriorly is the zygomatic process of the temporal bone, which forms the posterior portion of the zygomatic arch. Posteriorly is the mastoid portion of the temporal bone. Projecting...