Orbital complications following sinusitis still a problem: Our experience and results

El-Beltagy, Yasser; Hamdy, Tarek A.; Hasaballah, Mohamed Saad

doi:10.1016/j.ejenta.2014.07.001

Cited by 6 publications

(7 citation statements)

References 18 publications

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“…Clinical presentation differentiates different subgroups. 2 Patients with preseptal cellulitis will have only periorbital swelling and the extra ocular eye movements along with vision are normal, while in orbital cellulitis there will be extra ocular palsy and vision loss along with proptosis. 5 There can be isolated or pan sinus involvement with these complications.…”

Section: Discussionmentioning

confidence: 99%

“…Ethmoid sinus is the most common isolated sinus involved and pan sinus involvement indicates continuous mucosal inflammation and chronic disease. 2 Surgical management can be done by either endoscopic approach or external approach. When the endoscopic approach is difficult to locate the abscess (like in superior abscess), the external approach is indicated.…”

Section: Discussionmentioning

confidence: 99%

“…Sub periosteal abscess and orbital abscess are treated with immediate surgical drainage to prevent permanent vision loss. 2 Vision loss is secondary to optic neuropathy or by occlusion of optic vessels due to primary infiltration of disease process or secondary to increased intra ocular pressure. 6 It can even progress to meningitis and death.…”

Section: Discussionmentioning

confidence: 99%

“…These complications can be dealt either medically, surgically or combined depending on the extent of disease. 2 We took this study for enlightening the importance of orbital manifestations of sinus pathology and their deadly outcomes if timely interventions are not done.…”

Section: Introductionmentioning

confidence: 99%

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Varied orbital manifestations of paranasal sinus disease

Harugop

Mudhol

Bhimanapati

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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Background: Even though sinusitis is a common clinical entity, its complications are seen rarely after the advent of antibiotics. Hence we aimed to analyse varied clinical presentations and manifestations of orbital involvement in paranasal sinus diseases and their outcome.Methods: Hospital based prospective study done from January 2007 to December 2017. We selected 65 patients in our study based on our inclusion and exclusion criteria. Type of orbital involvement was analysed by computed tomography scan. Immediate aggressive medical management was started and surgery was undertaken if there is no clinical improvement in 48 hours. Endoscopic sinus surgery done along with orbital decompression and drained pus was sent for culture sensitivity. Patients were followed up regularly and suction clearance was done. Results: Out of 65 patients, 50 were male and 15 were female. 24 patients had bacterial pathology, 40 had fungal pathology and 1 patient had non specific inflammatory disease consistent with mucocoele. Out of 24 bacterial sinusitis, 2 had bilateral disease and 1 patient had scalp and neck extension. Out of 40 fungal sinusitis, 2 patients had 6th cranial nerve palsy with sphenoid disease, 5 patients had palatal extension and 8 patients had intracranial involvement.Conclusions: All cases of orbital oedema and proptosis should be thoroughly evaluated for sinus disease. Computed tomography aids to know the extent of disease, deciding about the type and mode of intervention. Early diagnosis and immediate intervention reduces significant mortality and morbidity. However regular follow up, counselling the patients and relatives helps in achieving appropriate outcome.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Varied orbital manifestations of paranasal sinus disease

Harugop

Mudhol

Bhimanapati

et al. 2019

Int J Otorhinolaryngol Head Neck Surg

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“…However inflammation of orbital contents may also lead to limitation of eye movement. Spread from ethmoid and maxillary sinuses can occur through retrograde thrombophelebitis (18). This early invasion may not be visible on radiological examination.…”

Section: Discussionmentioning

confidence: 99%

Invasive Rhinosinusitis due to Alternaria alternata and Rhizopus arrhizus Mixed Infection: A Case Report and Review

et al. 2016

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Introduction: Rhizopuse Sp. are common infectious agents of invasive rhinosinusitis. Though Alternaria is known to cause allergic rhinosinusitis, invasive sinusitis because of Alternaria Sp. is rare. Coinfections with bacteria and fungus causing rhinosinusitis have been reported as have the Rhizopus infection with other fungus such as Aspergillus, Candida, and Exserohillum. However Rhizopus coinfection with Alternaria has not been reported to the best of our knowledge. Case Presentation: A sixty-year-old woman was admitted with periorbital pain, swelling and complete restriction of movement of her right eye. She had diabetes mellitus for fifteen years. Diagnosis of invasive sinusitis was confirmed by hyperintensities in her right maxillary and bilateral ethmoid sinuses on the MRI on her brain and demonstration of hyphal forms from sinus mucosa. Culture confirmed the presence of Alternariaalternata and Rhizopus arrhizus. Patient responded to treatment with Amphotercin B and had complete resolution. Conclusions: Co-infection with bacteria and mixed fungal infection should be looked for as treatment strategies may differ with different organisms. Presumptive treatment should include agents, which can cover the broadest possible range of organism known to cause invasive sinusitis.

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