Clinical Presentation and Outcome of the Orbital Complications Due to Acute Infective Rhino Sinusitis

Abstract

To describe the clinical presentation and visual outcome of patients with orbital complications of acute infective rhino sinusitis. This is a retrospective case series of patients diagnosed with of orbital involvement due to acute infective rhino sinusitis, who presented to eye OPD between July 2007 and July 2009. The medical records were reviewed with particular emphasis on clinical presentation and management. Twelve patients with an average age of 40.3 years (range, 14-65 years) were studied. The most common presentating symptom was diminution of vision (66.6 %) followed by proptosis, ptosis (33.3 %) and globe displacement (16.6 %). The most common orbital complication noted was orbital cellulitis (83.3 %). Majority of the patients had multiple sinus involvement. Ethmoid sinus was the most common sinus involved (91.6 %). Surgical intervention was required in 75 % of patients. Three patients (25 %) were managed conservatively by intravenous antibiotics. This series highlights the risk of orbital involvement and visual loss in patients with para nasal sinusitis. Early diagnosis, aggressive medical and prompt surgical treatment by multidisciplinary approach can successfully treat the complications.

Clinical profile and outcomes of management of orbital cellulitis in Upper Egypt

“…Reported rates of an associated sinusitis with orbital cellulitis varied from 15 to 100% [9–13]. In the current study, orbital trauma was present in 13.7% of patients.…”

Characteristics of patients treated for orbital cellulitis: An analysis of inpatient data

“…Orbital cellulitis, frequently presenting secondary to paranasal sinusitis, is seen in both the pediatric and adult populations. [1][2][3] Due to the close relationship of the orbit to the paranasal sinuses, appropriate management and early diagnosis are critical to avoid serious complications that may jeopardize the integrity of the orbit and intracranial structures, resulting in permanent vision loss, optic neuropathy, cavernous sinus thrombosis, brain abscess, meningitis, and possibly death. 1,4,5 Chandler et al 4 first described the classification of orbital infections in 1970 that is still referenced today.…”

A descriptive study of the patients with orbital complication of acute and chronic sinusitis

“…8 In another retrospective study by Saroj Gupta 83.3 % patients presented with orbital cellulites as a complication of acute infective rhino sinusitis. 9 Age group in our study varied from 19 to 70 years with a mean of 54.85. Majority of the patients had fungal sinusitis which is common in immunocompromised patients.…”

“…In a two year retrospective study of 12 patients Gupta reported that the most common presenting symptom was diminution of vision (66.6%) followed by proptosis, ptosis (33.3%) and globe displacement (16.6%). 9 The most common orbital complication noted was orbital cellulitis (83.3%). Majority of the patients had multiple sinus involvement.…”