Recurrent unilateral periorbital cellulitis in a pediatric patient—An anatomic abnormality

Recurrent periorbital cellulitis in a very young child: A case report and review of literature

“…As expected, periorbital cellulitis has been found to be present concurrently with ethmoidal sinus disease [7][8][9][10]. Interestingly, for those patients with documented RPOC, an anatomic abnormality of the uncinate process obstructing the normal drainage pathway, in addition to ethmoidal sinusitis, was observed [7,8].…”

“…The direct venous connections between the orbits, nose and paranasal sinuses, along with bony breaches are thought to act as portals for infection between the nose and the orbits [4]. As expected, periorbital cellulitis has been found to be present concurrently with ethmoidal sinus disease [7][8][9][10]. Interestingly, for those patients with documented RPOC, an anatomic abnormality of the uncinate process obstructing the normal drainage pathway, in addition to ethmoidal sinusitis, was observed [7,8].…”

“…Only articles published in English were considered for the review. The search identified only two studies describing cases of recurrent unilateral periorbital cellulitis secondary to acute rhinosinusitis [7,8]. The patient described in the present report represents the earliest case of RPOC in the literature.…”

“…Computed tomography scans of the nose and paranasal sinuses have been commonly performed in patients with RPOC [7,8,11]. Yet, there is no clear evidence that CT, in light of the radiation exposure, is absolutely necessary in managing children with RPOC.…”

“…Yet, there is no clear evidence that CT, in light of the radiation exposure, is absolutely necessary in managing children with RPOC. Interestingly, in some cases nasal endoscopy was more helpful in analyzing the anatomy of the sinuses [7,8]. As well, since medical therapy is the first line intervention regardless of the CT results, and because very young children do not have fully developed bony paranasal sinuses, magnetic resonance imaging (MRI) may be more appropriate in pediatric RPOC cases.…”