Orbital complication following sinusitis still a problem: Our experience and results

Abstract

IntroductionThe orbital complications of sinusitis including cellulitis and abscess formation are well documented in both children and adults, but remain relatively uncommon. If left untreated, several complications such as orbital complications could progress rapidly, leading to optic neuritis, cavernous sinus thrombophlebitis or life-threatening intracranial complications and orbital cellulitis can manifest including blindness, meningitis, and even death.Material and MethodsA prospective and observational study of patients presented with orbital complication secondary to sinusitis in our Hospitals from January 2019 to December 2019.ResultsIn our study total 60 patients, male patients (63.3%) more common than women (36.6%) with a ratio of 1.7:1. Frequency of age groups of 1-20 years are 23 patients (38.3%) and least were more than 61 years old patients 5%. CT of orbits and sinuses was conducted in all patients, and sinusitis and preseptal cellulitis / orbital abscess was evident in all these cases. Maximum cases were Maxillary Sinusitis (n=41) and least were Sphenoid Sinusitis (n=3). In each of the patients with sinus disease, generally more than 1 ocular symptom were found. Proposes is the highest manifestation of ocular symptoms (n=30) due to diseases of the par nasal sinuses. Other ocular symptoms that least common were decrease visual acuity (n=3) and relative afferent pupillary defect present (n=4). All patients received intravenous antimicrobials, 7(11.6%) with amoxicillin/clavulanate alone, 2(3.33%) with ampicillin/ sulbactam alone, gentamicin in 12 (20%), and the other 39 (65%) with multiple antimicrobials.ConclusionOrbital complications, secondary to sinusitis, in the new millennium still pose a serious threat to patient’s vision and life; it can lead to irreversible damage if not treated aggressively. Medical treatment is efficient in early stages while surgical drainage (endoscopic or external) in preseptal, sub periosteal or orbital abscess.