Management options for orbital complications of acute rhinosinusitis in pediatric patients

Abstract

ObjectivesAcute bacterial rhinosinusitis (ABRS) is a common pediatric condition. Despite its tendency to heal without complications, orbital complications (OC) are seen in 6% of patients and can cause vision impairment and put life at risk. Current treatment of this complications involves systemic antibiotics with or without surgical drainage, remaining controversial the use of corticosteroids. The aim of this study is to describe our results in the management of this complication both through medical and surgical treatment, with the inclusion of corticosteroids on it. MethodsA retrospective cross-sectional study was conducted in a tertiary hospital over pediatric patients with this complication. Results23 patients were included with a mean age of 7.4 years. Ten of them (43.5%) presented ophthalmoplegia on admission and 2 of those also impaired visual acuity. A computerized tomography was performed in all patients and all of them received intravenous antibiotics and corticosteroids achieving that 60% did not require surgical treatment. The mean length of hospital stay was 6.2 days. ConclusionsThe treatment of OC of ABRS with intravenous antibiotics and corticosteroids is safe, remaining surgical treatment available when necessary. When evolution is favorable, a reduced hospital stay must be sought.