Abstract
Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3–4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians.
Highlights
Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in about 3–4% of children with acute rhinosinusitis [1], and mainly affect children aged less than five years [2]
SROIs are characterised by various clinical manifestations that may develop anteriorly or posteriorly to the orbital septum, a thin fibrous membrane extending from the orbital rims to the eyelids that acts as a barrier against the spread of external infections to the deep orbit
The aim of this paper is to provide an overview of the pathogenesis, diagnosis, and treatment of pediatric SROIs, and make some practical recommendations for attending clinicians
Summary
Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in about 3–4% of children with acute rhinosinusitis [1], and mainly affect children aged less than five years [2]. They are generally due to ethmoidal sinusitis spreading to the orbit, and are more frequent during winter. The clinical signs suggesting post-septal complications due to increased intra-orbital pressure are proptosis, chemosis, ophthalmoplegia, diplopia, impaired visual acuity, or impaired red-green visual perception [9]. The aim of this paper is to provide an overview of the pathogenesis, diagnosis, and treatment of pediatric SROIs, and make some practical recommendations for attending clinicians
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