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Predictors for surgical intervention in orbital complications of pediatric rhinosinusitis.
- Source :
-
European journal of ophthalmology [Eur J Ophthalmol] 2023 Sep; Vol. 33 (5), pp. 1867-1873. Date of Electronic Publication: 2023 Feb 15. - Publication Year :
- 2023
-
Abstract
- Objectives: Orbital complications are the most common complication of acute rhinosinusitis, especially among pediatric patients. While most cases are treated with antibiotics alone, severe presentation may demand surgical intervention. Our goal was to determine which factors predict the need for surgery and to investigate the role of computerized tomography in the decision process.<br />Methods: A retrospective review of all children hospitalized between 2001-2018 with orbital complications of acute rhinosinusitis in a university-affiliated children's hospital.<br />Results: A total of 156 children were included. Mean age was 7.9 years (1-18 years). Twenty-three children (14.7%) were surgically treated, and the rest were conservatively treated. High fever, ophthalmoplegia and diplopia in association with minimal or no response to conservative treatment were predictive for surgical intervention, as well as higher inflammatory indices. Eighty-nine children (57%) underwent imaging during hospitalization. Presence of a subperiosteal abscess, as well as its size and its location were not found to be predictors for surgery.<br />Conclusion: Clinical and laboratory findings in association with minimal or no response to conservative treatment predict the need for surgical intervention in cases of orbital complications of acute rhinosinusitis. As Computerized Tomography scans can have long-term implications in the pediatric population, caution and patience should be practiced when deciding on the timing of imaging in this population. Thus, close clinical and laboratory monitoring should lead the decision-making process in these cases and imaging should be reserved for when the decision for surgery has been made.
- Subjects :
- Child
Humans
Abscess etiology
Abscess surgery
Retrospective Studies
Tomography, X-Ray Computed
Hospitalization
Acute Disease
Anti-Bacterial Agents therapeutic use
Rhinitis complications
Rhinitis surgery
Rhinitis drug therapy
Sinusitis complications
Sinusitis surgery
Orbital Diseases diagnosis
Orbital Diseases etiology
Orbital Diseases surgery
Subjects
Details
- Language :
- English
- ISSN :
- 1724-6016
- Volume :
- 33
- Issue :
- 5
- Database :
- MEDLINE
- Journal :
- European journal of ophthalmology
- Publication Type :
- Academic Journal
- Accession number :
- 36793220
- Full Text :
- https://doi.org/10.1177/11206721231156987