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Orbital complications of pediatric rhinosinusitis: A single institution report
Göksel Turhal1, Sercan Göde1, Baha Sezgin1
1Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir.
Insights
Pediatric rhinosinusitis can lead to serious orbital complications. Early diagnosis and appropriate treatment, including conservative therapy for preseptal cellulitis, significantly reduce morbidity and mortality in children.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Ophthalmology
Background:
- Rhinosinusitis is a common childhood infection.
- Orbital and intracranial complications can arise, though rare.
- This study focuses on pediatric rhinosinusitis with orbital complications.
Purpose of the Study:
- To retrospectively analyze treatments and outcomes.
- To evaluate pediatric rhinosinusitis patients with orbital complications.
- To assess the effectiveness of medical and surgical interventions.
Main Methods:
- Retrospective analysis of 25 pediatric patients (2008-2016).
- Collected data on orbital complications, clinical findings, imaging, and blood counts.
- Assessed hospitalization duration, infection source, and prior treatments.
Main Results:
- Mean patient age was 8.84 years; average hospitalization was 6.72 days.
- Subperiosteal abscess cases had significantly longer hospital stays (8.43 days) than preseptal cellulitis (5.21 days).
- Surgically treated patients trended towards longer hospitalizations, but not significantly.
Conclusions:
- Early diagnosis and appropriate treatment minimize morbidity and mortality from orbital complications.
- Conservative therapy is effective for preseptal cellulitis and most orbital cellulitis cases in children.
- Prompt management is crucial for favorable outcomes in pediatric rhinosinusitis with orbital involvement.
Background And Objectives:
Rhinosinusitis is one of the most common infections of childhood. Rhinosinusitis usually limits itself in the pediatric age group, however orbital and intracranial complications may arise in some of the patients. The purpose of the study was to retrospectively analyse the previous treatments and outcomes in pediatric rhinosinusitis patients with orbital complications.
Methods:
The effect and prognosis of medical treatment and endoscopic sinus surgery are reported in this study. Twenty-five pediatric patients diagnosed with complicated rhinosinusitis between January 2008 - February 2016 were included in the study. Orbital complications, examination findings, radiological imaging and blood counts were retrospectively collected from patient files. The duration of hospitalization, source of the infection, complications, previous medical and surgical treatments were also retrospectively assessed.
Results:
Average age of the patients were 8.84 ± 4.02 years (range: 1-16 years). The mean length of stay in hospital was 6.72 ± 3.28 days. Hospitalization in surgically treated group was higher than primarily medically treated group. However this difference could not reach to a statistically significant level (p > 0.05). Mean hospitalization time was found 5.21 ± 2.51 and 8.43 ± 2.87 days in patients diagnosed with preseptal cellulitis and subperiosteal abscess respectively. Hospitalization in patients with subperiosteal abscess was higher than preseptal cellulitis and a statistically significant difference was detected (p < 0.05).
Conclusion:
Morbidity and mortality of orbital complications which are the most common complications of pediatric rhinosinusitis, could significantly be reduced by using appropriate treatment methods and an early diagnosis. Conservative therapy is an effective method for patients with preseptal cellulitis and most cases of orbital cellulitis in children.
