Orbital complications of acute sinusitis in children

Purpose. Acute sinusitis with orbital complications is an ambiguous disease. Without timely diagnosis and appropriate management, it may lead to ocular squela and even become a life-threatening disease. The purpose of this study was to evaluate the clinical presentation, diagnosis, management and outcome of orbital complications of acute sinusitis in children treated at our hospital over a 10-year period. Methods. We retrospectively reviewed 23 children with orbital complications of acute sinusitis who were admitted to our hospital from January 1995 to July 2004. The clinical presentation, laboratory examination, radiological examination, bacteriology, and treatment method were analyzed. Results. The mean age of the patients was 5.0 years, and 65% of patients were younger than 5 years. The mean hospitalization was 8.0 days. Computerized tomography confirmed medial subperiosteal abscess in six children and orbital abscess in three children. Six children underwent surgical intervention. One child had the same blood and pus results: Staphylococcus haemolyticus. Neither cavernous sinus thrombosis nor intracranial infection was noted. No sequela was found in these 23 patients during a follow-up period of 1 to 2 months. Conclusions. Orbital inflammation is the most common complication of acute sinusitis in children. Computerized tomography is very useful for staging orbital inflammation and guiding surgical intervention.