Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

Abstract

Background: The orbital complications account for about 80% of all complications secondary to acute rhinosinusitis. If the treatment is not correct and in time, orbital complica-tions could progress rapidly, leading to optic neuritis, cav-ernous sinus thrombophlebitis or life-threatening intracra-nial complications. Aims: To evaluate the therapeutic efficacy of conservative therapy for the patients with orbital cellulitis and endoscop-ic sinus surgery (ESS) performed on patients with subperi-osteal abscess (SPA) secondary to acute rhinosinusitis in children.Study Design: Retrospective cross-sectional study.Methods: The retrospective study included 31 pediatric patients with orbital complications secondary to acute rhi-nosinusitis. In all cases, intensive treatment was initiated with a combination of oral or intravenous antibiotics, glu-cocorticoid and gelomyrtol forte after admission. ESS was performed if an improvement in the condition of patients did not occur after 48 hours. However, the patients with or-bital SPA, motility disorders of eyeball or decreased vision received ESS immediately within 24 hours. Results: Sixteen patients were cured by conservative ther-apy and 15 patients by ESS. All of the signs and symptoms disappeared after conservative therapy or ESS. There were no recurrences within the follow-up period of 1 to 8 years. Conclusion: Conservative therapy is an effective method for patients with inflammatory edema and most cases of or-bital cellulitis in children. SPA can be cured by ESS.