Orbital complications of pediatric rhinosinusitis: A single institution report

Background and objectives. Rhinosinusitis is one of the most common infections of childhood. Rhinosinusitis usually limits itself in the pediatric age group, however orbital and intracranial complications may arise in some of the patients. The purpose of the study was to retrospectively analyse the previous treatments and outcomes in pediatric rhinosinusitis patients with orbital complications. Methods. The effect and prognosis of medical treatment and endoscopic sinus surgery are reported in this study. Twenty-five pediatric patients diagnosed with complicated rhinosinusitis between January 2008 - February 2016 were included in the study. Orbital complications, examination findings, radiological imaging and blood counts were retrospectively collected from patient files. The duration of hospitalization, source of the infection, complications, previous medical and surgical treatments were also retrospectively assessed. Results. Average age of the patients were 8.84 +/- 4.02 years (range: 1-16 years). The mean length of stay in hospital was 6.72 +/- 3.28 days. Hospitalization in surgically treated group was higher than primarily medically treated group. However this difference could not reach to a statistically significant level (p >0.05). Mean hospitalization time was found 5.21 +/- 2.51 and 8.43 +/- 2.87 days in patients diagnosed with preseptal cellulitis and subperiosteal abscess respectively. Hospitalization in patients with subperiosteal abscess was higher than preseptal cellulitis and a statistically significant difference was detected (p <0.05). Conclusion. Morbidity and mortality of orbital complications which are the most common complications of pediatric rhinosinusitis, could significantly be reduced by using appropriate treatment methods and an early diagnosis. Conservative therapy is an effective method for patients with preseptal cellulitis and most cases of orbital cellulitis in children.