Orbital Complications of Acute Sinusitis: Evaluation, Management, and Results

Abstract

Introduction Even though orbital complications in acute rhinosinusitis are not very common, they can be very severe complications, with high mortality rates, due to infection spreading to orbital and intracranial tissues (1). Especially due to intracranial complications, acute rhinosinusitis is considered in the life-threatening disease group. As per Chandler et al. (2), orbital complications are classified into five groups according to the severity of complications: preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess, and cavernous sinus thrombosis. Although orbital complications are clinically rare, they are more common in children than in adults. Orbital septum acts as a barrier that prevents the spread of inflammation from the preseptal region towards the orbital space. Along with proptosis, limitation of eye movements, and decrease in vision, the presence of redness, edema, and local temperature increase in the eyelids, i.e., infectious pathology of orbital region, suggest intraorbital propagation. Especially in the childhood period, compared to adult age groups, infections in the preseptal region that did not receive proper treatment can spread easily in the orbits and cause serious complications such as brain abscess, meningitis, and cavernous sinus thrombosis (1-4). Although antibiotic use reduces the incidence of sinus infections and complications, acute sinusitis is still the leading cause of orbital inflammation and impaired vision. Particularly after frequent upper respiratory infections during the childhood, the infection that spreads easily to the nose and sinuses sets the ground for orbital complications (4-6). In our study, accompanied by diagnosis, treatment, and follow-up symptoms of 11 patients who developed orbital complications of rhinosinusitis, treatment and follow-up algorithm of orbital complications have been revised with literature data. 131