Varied orbital manifestations of paranasal sinus disease (original) (raw)
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Orbital Complications of Sinusitis A Review
Otolaryngology online journal, 2014
Introduction: Despite availability of excellent antibiotics, orbital complications’ following sinusitis is rather common. With the emergence of fungal sinusitis orbital involvement by the disease is getting frequent. Prevalence of life style disorders like diabetes mellitus has added to the woes. This article attempts to review the entire gamut of orbital complications following sinus infections. Aim: This study aims at analyzing orbital complications following sinusitis at Government Stanley Medical College Hospital during the period 2009 – 2013. Study design: Retrospective study Methodology: Cases with rhinosinusitis treated in our Institution during the period 2009-2013 were taken up for analysis. 112 patients were chosen for the study. Their case records were analyzed. CT scan images taken during the time of admission were also evaluated. Patients with orbitalcomplications following rhinosinusitis were included. Chandler’s classification was used to categorize the stage of disease. Results: 112 patients were included in the study. 76 Male patients 36 Female patients 26 patients developed orbital complications Number of male patients with orbital complication – 22 Number of female patients with orbital complication – 4 Number of patients who died due to complications - 2 Conclusion: High degree of suspicion, early diagnosis and aggressive medical management of Chandler’s categories I and II will go a long way in preventing irreparable damage to vision. All our patients were managed initially with parenteral antibiotics. Patients who do not show improvement even after 4 days of antibiotic therapy were taken up for surgical management.
Orbital Infection as a Complication of Sinusitis: Are Diagnostic and Treatment Trends Changing?
Ear, Nose & Throat Journal, 2002
Orbital infection has long been the most common complication of sinusitis. In light of our increased knowledge of sinusitis, improved diagnostic tools, and new pharmacologic and surgical treatments, we investigated whether trends in diagnosis and treatment are changing. We reviewed the charts of all 43 patients who had been referred to our institution with orbital complications of sinusitis between Jan. 1, 1985, and Dec. 31, 1999. Nine of the 43 patients had been diagnosed between Jan. 1, 1985, and Dec. 31, 1990 (mean: 1.5 patients/yr) and 34 had been diagnosed between Jan. 1, 1991, and Dec. 31, 1999 (mean: 3.8 patients/yr). Of the 43 patients, 27 had cellulitis and 16 had an abscess (one of the 16 had two abscesses—one subperiosteal and one supraorbital). All 17 abscesses were treated surgically. Five of the 7 abscesses operated on from 1985 through 1990 were treated via an open external approach, whereas 7 of the 10 abscesses that were operated on later were treated via an endosco...
Managment of orbital complications of sinusitis
Arquivos Brasileiros de Oftalmologia, 2014
INTRODUCTION Sinusitis is a common disease and is typically managed without complications. In some cases, infection can spread to the orbit. If left untreated, several complications of orbital cellulitis can manifest including blindness, meningitis, and even death (1). Kanra et al. reported that orbital cellulitis was caused by sinusitis in 43% of cases (2). Other etiologies were dacryocystitis, orbital foreign body, periocular trauma, history of surgery, odontogenic infection, endophthalmitis, orbital tumors, and local skin inflammation (2,3). Before the antibiotic era, 20% of patients with periorbital cellulitis had permanent loss of vision, and 17% died (1). Nowadays, the vision loss has improved (3 to 11%) and mortality rates have declined (1 to 2.5%) (4). Because of the urgent situation in orbital infections, a multidisciplinary approach is needed. The orbital septum originates from the periosteum and, arising from the anterior extension of the periosteum from the orbital margins into the eyelids, separates the superficial portion of eye (preseptal region) from the deeper orbital structures (postseptal region) (5). Chandler et al. described orbital complications as five stages (1) : preseptal cellulitis (stage I), orbital cellulitis (stage II), subperiosteal abscess (stage III), orbital abscess (stage IV), and cavernous sinus thrombosis (stage V). However, identifying the stages in children with Managment of orbital complications of sinusitis Tratamento das complicações orbitais da sinusite
Orbital complications of acute rhinosinusitis
International Bulletin of Otorhinolaryngology, 2018
Introduction. Rhinosinusitis is the infection and inflammation of at least one of the 4 paranasal sinuses (frontal, maxillary, ethmoid and sphenoid). Their correct diagnosis is generally determined by examining the patient clinically and by rhinosinusal endoscopic examination. There are also cases that show complications or continued evolution despite the correct treatment, and then we will use some imaging investigations to find out more about affection(radiography of anterior sinuses of the face, sinus computerized tomography, sinus magnetic resonance imaging). In particular, acute rhinosinusitis should be carefully managed to avoid complications such as the local ones: orbital cellulitis, orbital abscess, osteomyelitis, cavernous sinus thrombosis; and intracranial complications: meningitis, epidural abscess, subdural abscess, cerebral abscess. Materials and methods. There will be presented all orbital complications according to the cases treated in the ENT Clinic of the Coltea Clinical Hospital. Conclusions. Diagnosis of rhinosinusitis is largely clinical and endoscopic. When complications of the condition arise, these should be investigated imagistically to determine their exact extent and to institute the correct treatment as soon as possible. The complications of rhinosinusitis are medical and surgical life-threatening emergencies, which is why in order to diagnose and correct and quickly institute therapy requires a multidisciplinary approach.
Orbital Complications of Acute Sinusitis: Evaluation, Management, and Results
Turk Otolarengoloji Arsivi/Turkish Archives of Otolaryngology, 2014
Original Investigation Objective: Even though acute rhinosinusitis orbital complications are not very common, they can appear as very severe complications with high mortality rates, due to infection spreading to orbital and intracranial tissues. The objective of this study is to assess the treatment and its results for patients treated in our clinic due to rhinosinusitis complications. Methods: Patients who were admitted to our clinic due to acute rhinosinusitis complications between January 2010 and March 2012 were examined. We retrospectively evaluated 11 patients 8 (73%) males and 3 (23%) females with a mean age 12.36 years (range 6-20 years)who were treated for orbital complications of acute rhinosinusitis. Cases were evaluated according to age, sex, etiologic factors, localization, treatment, and outcome. Results: Preseptal cellulitis was observed in 9 patients (82%), orbital abscess was observed in 1 patient (9%), and subperiosteal abscess was observed in 1 patient (9%). Ten of 11 patients achieved full recovery through medical treatment, whereas 1 patient was treated with right subperiosteal abscess drainage and right functional endoscopic sinus surgery due to subperiosteal abscess. The patients' average admission duration was 7 days. Conclusion: The orbita is the area with the most common sinusitis complications, due to its proximity to the paranasal sinuses and especially to ethmoid cells. Early diagnosis and aggressive treatment are important for the reduction of unwanted manifestations. Computed tomography with contrast remains the optimal imaging study for orbital inflammation. Surgical treatment is indicated when subperiosteal orbital abscess and orbital abscess are scenes.
Oral and Maxillofacial Surgery, 2012
Background Orbital infection is an uncommon devastating infection and is usually a complication of paranasal sinus infection. Without appropriate treatment, orbital infection may lead to serious complications, even death. Prompt treatment is mandatory to avoid visual loss or intracranial complications. The literature shows that initially, intravenous antibiotics should be administered, and after 48 h, if no improvement appears, the affected orbit and the sinuses must be surgically drained. The authors describe two cases of orbital cellulitis with a brief literature review. Case report The authors describe two cases of orbital abscess caused by paranasal sinus infection. In case 1, the patient presented a decreased visual acuity associated with ophthalmoplegia of the right eye. In case 2, the patient presented a decreased visual acuity. Thus, administration of intravenous antibiotic combined with surgical drainage was performed. After surgical procedure, eye movements were normalized in case 1, and in both patients, the visual acuity returned to normal parameters. Discussion The authors recommend early surgical drainage with parenteral antibiotic administration and careful postoperative observations by monitoring the signs and symptoms of the orbital complaint.
Complications of nose and paranasal sinus disease
Journal of Ayub Medical College, Abbottabad : JAMC
Diseases of nose and paranasal sinuses can complicate to involve the orbit and other surrounding structures because of their close proximity. These diseases are usually infective or can be neoplastic in origin. All the patients presenting in ENT or Eye Departments of Ayub Teaching Hospital during the one year study period who had complicated nose or paranasal sinus disease were included in the study. A detailed history and examination followed by CT scanning and laboratory investigations to assess the type and extent of the disease, was carried out. Infections were the most common cause of complicated sinus disease 11 (75%). The rest of the 4 (25%) cases were tumours. 12 (80%) of the cases presented with proptosis. In I of these 12 cases. there was complete blindness. In 2 (13%) of the cases there was only orbital cellulitis. Two of these patients had facial swelling and 2 had nasal obstruction and presented as snoring. Two patients presented with history of weight loss and these pa...
Paranasal Sinuses and Nasal Cavity
The Professional Medical Journal, 2011
Objectives: To describe the clinical and neuro-radiological patterns of orbital invasion by the sino-nasal diseases. Study Design: Descriptive, Retrospective study. Period: 2004 to 2009. Subjects and Methods: We retrospectively reviewed fifty four cases of nasal and paranasal sinus diseases invading the orbit. The medical charts were analyzed. The data considered for the study was age, sex, ocular presentation and associated systemic problems of the patients. The neuro-radiological results were correlated with the clinical picture. Results: The age range was from 6 to 85 years (mean 45.5). Male to female ratio was 3.5: 1. The initial clinical presentation was Proptosis (66.66%), disturbance of vision (25.9%), ophthalmoplegia (11.11%), diplopia (9.26%) and ptosis (9.26%). 79.63% patients had inflammatory etiology and 20.4% had neoplastic lesions in the nasal and paranasal sinuses extending into the orbit.