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Article Published In Vol.4 (Nov-Dec-2016)

Prevalence of orbital complications in acute rhinosinusitis

Author : Hazim Mohammed Khudhair FICMS(ENT) CABS(ORL-HNS), Salam Masood Hanash, FICMS, Maha Faeq Majeed FICMS, Thamer Mohsen Abbas FICMS

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Background: Orbital complications can occur in patients with acute rhinosinusitis, ranging from simple eyelid edema (preseptal cellulitis), which is the commonest, to vision and life threating conditions like orbital abscess and cavernous sinus thrombosis. Accurate early diagnosis is essential.
Aim of study: To evaluate the prevalence of orbital complications of acute rhinosinusitis.
Patient and methods: A prospective study was carried out at Otorhinolaryngology department at Ghazi Al-Hariri Surgical Specialties Hospital, Medical City Complex, Baghdad during period from January 2013 to December 2014. Cases already diagnosed as acute rhinosinusitis where included in the study, then cases with orbital complications were selected, clinically and radiologically evaluated, then classified into two groups according to their ages. First group was below 18 years, other group above 18 years. Types of complications, site and sinus involved and clinical presentation were compared in each group.
Results: A total number of patients were (568). Orbital complications were present in (34) patients (6.0%). Twenty patients (58.8%) were children, (15) had preseptal cellulitis, (3) orbital cellulitis, (2) had orbital abscess. Preseptal cellulitis was the commonest complication in children. Fourteen patients were adults (41.2%), (6) with subperiosteal abscess, (4) with preseptal cellulitis, (2) with orbital cellulitis, (2) with orbital abscess. Subperiosteal abscess was the commonest complication in adults.Commonest isolated sinus infection was ethmoid, sphenoid was the least affected. While maxillary and ethmoid affection were the commonest mixed sinus involved.
Conclusion: Orbital complications of acute rhinosinusitis are not uncommon, being more common in children than adults.

Keywords: Orbital complications, acute rhinosinusitis, preseptal cellulitis,orbital cellulitis, subperiosteal abscess.

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