Orbital Complications and Prognosis of Acute Ethmoiditis: A Pediatric Retrospective Observational Study

IntroductionOrbital involvement is a serious complication of ethmoiditis in children, often occurring because the ethmoid sinuses are very close to the orbit. Our work aimed to report the clinical presentation, treatment modalities and the outcome of orbital complications of acute ethmoiditis to identify common indicators for surgery.MethodsRetrospective observational study to review cases that were hospitalized in pediatrics and otorhinolaryngology departments of the Farhat Hached Hospital in Sousse, Tunisia, during the period from January 2013 to December 2023.ResultsWe collected 79 cases. The mean age was 4,55±3,64 years old. Five of our patients had anemia, six had allergic rhinitis, and one had asthma. Two other patients had undergone recent dental care. Palpebral edema and fever were the most frequently reported symptoms. A palpebral abscess was present in five cases, while nineteen cases exhibited exophthalmos. Seven children had limited occulomotricity, and one child had ophthalmoplegia.In addition, reduced visual acuity was reported in 3 cases. Referring to Chandler's stratification, we report 37 cases of preseptal cellulitis, 10 cases of orbital cellulitis and, 31 cases of subperiosteal abscess. Eleven patients required surgical treatment consisting of orbitotomy. Age equal to or above 5 years old was more associated with surgical treatment (p<0.001). The outcome was generally favorable.ConclusionOrbital complications of acute ethmoiditis are a low-prevalence high risk disease. Most patients are successfully treated without long-term complications. Younger children (<5 years) are less likely to undergo surgery.