Abstract
Objective: Paranasal sinus infections are one of the most frequent causes of emergency service admissions. With increased incidence, complications are often local and classified according to the effecting side. Early identification of complication leads to reduce mortality and morbidity. Case: A 22 year old male patient was admitted to our emergency department with ptosis on his right eyelid. Firstly he was admitted to the family doctor and received oral cephalosporin treatment for upper respiratory tract infection. Within three days, the ptosis was progressively occurred. No additional systemic sign was detected. The eyelid has slightly edema, not have redness, conjunctival hyperemia and loss of brow not observed. Eye movements were naturally, display pain in the outward view. For differential diagnosis central nervous system imaging was performed. Patient referred to otorhinolaryngology surgeon with prediagnosis of orbital cellulite and acute sinusitis. The patient was admitted to the otorhinolaryngology clinic for operation because of complicated sinusitis. Conclusion: In the presence of acute sinusitis, infections may enter the orbital periosteum and spread to neighboring tissues. Computed tomography is a highly effective imaging modality for the evaluation of both paranasal infections and their complications. Patients with orbital complications must be hospitalized and immediate intravenous antibiotic therapy should be started.
Highlights
Paranasal sinus infections are a common group of diseases, complications are rarely occur due to appropriate antibiotic uses
Complications of sinusitis are usually classified according to the effecting side as local complications, orbital complications and intracranial complications
These stages are classified as preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess and cavernous sinus thrombosis according to the severity of the clinical presentation [1, 2]
Summary
In the presence of acute sinusitis, infection may enter the orbital periosteum and spread to neighboring tissues. Depending on the severity of the infection and orbital complications proptosis, bulbus motion restriction, chemosis, diplopia, pupillary reflex reduction, decreased visual acuity and even permanent visual loss can be seen. Every patient considered to have orbital complications should be asked for an ophthalmology consultation to assess the eye movements and their visual acuity. Patients with orbital complications should be hospitalized and immediate intravenous antibiotic therapy should be started. If orbital abscess is detected despite antibiotic treatment, urgent surgical drainage is advised in case of complaints such as limitation of eye movements, decrease in visual acuity, following eye consultation. Keeping in mind the orbital complications can prevent permanent visual loss and allows the patient to receive appropriate treatment. Responsibilities of research, responsibilities against local ethics commission are under the Authors responsibilities. The study was conducted under defined rules by the Local Ethics Commission guidelines and audits
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