Complications of pediatric paranasal sinusitis

Abstract

Acute paranasal sinus infection in children is often diagnosed clinically without the need for radiographic confirmation. Most cases have a favorable outcome following appropriate antibiotic therapy. A small percentage of cases where symptoms and signs are persistent or severe will require emergent imaging to rule out complications related to local spread of disease intraorbitally or intracranially. A strong index of suspicion is required in such cases, and cross-sectional imaging evaluation with CT and MRI should include axial and coronal images of the paranasal sinuses and, where appropriate, the orbits and brain (with attention to the cavernous sinus). There is no role for plain radiography in the evaluation of the complications of acute sinusitis in the pediatric patient.

Orbitale Komplikation einer akuten Sinusitis

“…Weitere in der Literatur beschriebene vital bedrohliche Komplikationen einer Sinusitis umfassen Sinusvenenthrombose, Meningitis, Enzephalitis, parenchymale Abszessbildung und zerebralen Infarkt [4]. Die in unserem Fall beobachtete milde traumatische oder kompressive Optikusneuropathie stellt eine der weniger schweren okulären Komplikationen dar.…”

Incidental Findings in Paranasal Sinuses and Mastoid Cells: A Cross-Sectional Magnetic Resonance Imaging (MRI) Study in a Pediatric Radiology Department

“…The reason why radiologists are eager not to overlook signs of sinusitis may be due to the fact that early diagnosis and treatment are crucial to avoid intraorbital or intracranial extension. The actual diagnosis may be difficult because clinical symptoms overlap with those of non-specific upper respiratory tract (URT) infection [4, 10,11]. A review of the literature shows that recent radiological publications on this diagnostic dilemma are rare.…”

Endoscopic Drainage of Orbital Subperiosteal Hematoma Secondary to Acute Rhinosinusitis in a Child

“…Orbital complications secondary to sinusitis are mostly orbital infections and can be staged according to Chandler's classification (Chandler et al 1970) into five groups (Group I: inflammatory edema, Group II: orbital cellulitis, Group III: subperiosteal abscess, Group IV: orbital abscess, Group V: cavernous sinus thrombosis). Subperiosteal abscess is the most common intraorbital complication in the pediatric population (Reid 2004). In children, the periosteum at the medial orbital wall is loosely attached to the underlying lamina papyracea (Reid 2004).…”

“…Subperiosteal abscess is the most common intraorbital complication in the pediatric population (Reid 2004). In children, the periosteum at the medial orbital wall is loosely attached to the underlying lamina papyracea (Reid 2004). A recent review of cases of pediatric subperiosteal abscess suggested that immediate surgical intervention is not always the best treatment option (Bedwell and Bauman 2011;Bedwell and Choi 2013).…”

“…Using stringent criteria to define acute sinusitis, it has been observed that be-tween 6% and 7% of children seeking care for respiratory symptoms has an illness consistent with this definition (Wald et al 2013). Acute rhinosinusitis is frequently associated with secondary orbital infection, most commonly subperiosteal abscess in children (Reid 2004). Subperiosteal abscess and orbital abscess are severe types of orbital infection.…”