Post-septal orbital complications of acute bacterial rhinosinusitis: Endoscopic anatomical considerations

Abstract

Orbital complication of acute sinusitis is not an uncommon condition, especially in children and young adults. Many cases can be successfully managed medically with antibiotics, but if the condition has not improved or rapidly progressed, it results in catastrophic local sequelae. This study aims to analyze the possible relationship between sinonasal anatomic variation and the incidence of orbital infections complicating acute sinusitis. A management protocol amalgamating both clinical and radiological criteria is presented.The study was carried out on 240 patients suffering from acute rhino-sinusitis with 90 patients suffering from orbital post-septal complicating acute rhino-sinusitis. Eighty-five cases underwent orbital decompression, except 5 cases with orbital cellulitis; they were improved on medical treatment. Visual monitoring by the ophthalmological team on regular basis was performed, until clinical and radiological improvement of the condition. This study proves that there may be a relationship between anatomic variation and orbital infections complicating acute sinusitis or acute on top of chronic sinusitis.