Abstract
The methods for the treatment of orbital complications of rhinosinusitis are often debated: conservative, surgical or combined. Surgical options include both endoscopic and open surgery. However, in the era of endoscopic surgery of the nose and paranasal sinuses, there are still no clear advantages of these techniques over open interventions. Therefore, our study aimed to clarify and evaluate the results of intranasal endoscopic procedures performed in individuals with orbital complications of rhinosinusitis in search for optimal treatment of this group of patients. 30 patients were divided based on Velasco classification into 3 groups; 1st group (14 patients) for patients with orbital cellulitis, 2nd group (10 patients) for patients with subperiosteal orbital abscess and the 3rd one (6 patients) was for patients with intraorbital abscess. Endoscopic endonasal surgery was done for all patients in group II and III and in 4 patients indicated for surgery in group I. Our result showed a highly significant postoperative improvement in proptosis, ocular motility, diplopia and vision acuity. Conclusion: Endoscopic Sinus Surgery offers a convenient, safe, and effective alternative to open procedures and can be successfully performed in well-selected cases of orbital complications of rhinosinusitis with many advantages.
Highlights
Complications in acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS) are orbital (60–75%), intracranial (15–20%) or osseous (5–10%) (Chandler et al, 1970).Orbital infections were initially classified into five stages by Chandler and later modified by Moloney, Kastenbauer, Stammberger and Mortimore.the most widely used classification was introduced by Chandler et al, published in 1970, but these classifications did not consider the orbits anatomical characteristics
One should keep a low threshold for surgical intervention within 24-28 h if patients are poorly responding to the antibiotics, while surgery is always indicated in more advanced stages especially with worsening visual acuity (Siedek et al, 2010)
The purpose of the article is to clarify and evaluate the results of intranasal endoscopic procedures performed in individuals with orbital complications of rhinosinusitis in search for optimal treatment of this group of patients
Summary
Complications in acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS) are orbital (60–75%), intracranial (15–20%) or osseous (5–10%) (Chandler et al, 1970).Orbital infections were initially classified into five stages by Chandler and later modified by Moloney, Kastenbauer, Stammberger and Mortimore.the most widely used classification was introduced by Chandler et al, published in 1970, but these classifications did not consider the orbits anatomical characteristics. Complications in acute rhinosinusitis (ARS) or chronic rhinosinusitis (CRS) are orbital (60–75%), intracranial (15–20%) or osseous (5–10%) (Chandler et al, 1970). Orbital infections were initially classified into five stages by Chandler and later modified by Moloney, Kastenbauer, Stammberger and Mortimore. The most widely used classification was introduced by Chandler et al, published in 1970, but these classifications did not consider the orbits anatomical characteristics. Valesco et al proposed a new, more objective classification classifying orbital complications of rhinosinusitis into 3 classes as follow:-. One should keep a low threshold for surgical intervention within 24-28 h if patients are poorly responding to the antibiotics, while surgery is always indicated in more advanced stages especially with worsening visual acuity (Siedek et al, 2010)
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