Abstract
The ocular-orbital complications of sinusitis constitute a diagnostic and therapeutic urgency that requires a correct multidisciplinary assumption. Objectives: The description of clinical and therapeutic data of the orbital complications of acute sinusitis. Methods: Our work is based on a retrospective study of 86 cases of ocular-orbital complications of sinusitis hospitalized at the ENTdepartment of Hassan II Hospital in Fes (Morocco), between the years of 2006 and 2014. Results: It is about 56 men and 30 women. The average age was 24 years, with the extremes of 3 years and 65 years. The average time of consultation was 13 dates. The achievement was frontal-ethmoido in 26 cases, and it is about a pan sinusitis in 24 cases. About 13% and 7% of cases were classified respectively in the stage III and the stage IV of chandler. The surgery was done for 24 cases. Bacteriological sample was performed among 24 patients and allowed to isolate a streptococcus (3.5%), and a staphylococcus (5.8%), and a poly microbial flora for 15.1% of patients. A death in sepsis panel was noted for a patient who presented a thrombosis of cavernous sinus. And we have noted a persistent left exophthalmia without the diminution of visual acuity for another patient. Conclusion: The orbital complications of sinusitis require a multi-disciplinary medical approach associated to ear specialist, ophthalmologist, and neuro-radiology. A precocious diagnosis, an appropriate anti-biotic therapy, and sometimes an associated surgical treatment, can significantly diminish the mortality and the morbidity related to this pathology.
Highlights
The ophthalmologic complications of chronic and acute sinusitis are more frequent than the cranial and endocranial complications [1] [2]
The severity of complications attached to the sinus infections resides in the risk of blindness by damage of the optic nerve
Current thinking supports that the pathogenesis of these complications is predominantly a multifactorial inflammatory disease [1] [3]
Summary
The ophthalmologic complications of chronic and acute sinusitis are more frequent than the cranial and endocranial complications [1] [2]. The severity of complications attached to the sinus infections resides in the risk of blindness by damage of the optic nerve. Current thinking supports that the pathogenesis of these complications is predominantly a multifactorial inflammatory disease [1] [3]. The role of bacteria in the pathogenesis of these complications; is currently being reassessed. Repeated and persistent sinus infections can develop in persons with severe acquired or congenital immunodeficiency states or with a disruption of the intrinsic mucociliary transport system [5] [6]
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