Patient: Female, 17-year-old Final Diagnosis: Periorbital abscess • retinal artery and vein occlusion Symptoms: Blindness • nasal congestion • pain the eye • proptosis Medication: — Clinical Procedure: Drainage • endoscopic sinus surgery Specialty: Otolaryngology Objective: Unusual clinical course Background: Periorbital abscesses are uncommon complications of acute bacterial rhinosinusitis; with the evolution of diagnostic and therapeutic methods, it is rare that the patient progresses to irreversible blindness. Central retinal artery occlusion (CRAO) and central retinal vein occlusion (CRVO) rarely occur simultaneously and the factors that influence this occurrence are not well understood. Case Report: This is a case report of an immunocompetent healthy adolescent girl, who developed irreversible blindness caused by a periorbital abscess secondary to acute bacterial rhinosinusitis due to CRAO and CRVO. Despite 6 days of clinical treatment, including intravenous antibiotics (vancomycin-associated piperacillin with tazobactam), she had a large periorbital abscess and could not open her left eye. Therefore, she was transferred to a tertiary hospital; 1 day after her admission, she underwent surgical treatment to drain the abscess through external and endoscopic access. In addition, she received broad-spectrum antibiotics (meropenem with vancomycin) for 3 weeks. She was no longer able to perceive light with the left eye, despite her clinical improvement. This case report discusses the factors that could have contributed to this poor outcome, despite clinical and surgical treatment. Conclusions: We conclude that there are several mechanisms that can lead to the loss of vision and when the indicated surgical intervention is delayed, it can increase the risk of visual sequelae.

Objective: To assess the clinical and epidemiological profile of patients with olfactory dysfunction in the scenario of COVID-19 pandemic. Methods: The study selected patients with loss of smell, previously screened by telemonitoring system of the Municipal Health Department of Goiânia (GO), Brazil, who agreed to answer a questionnaire about COVID-19 symptoms and findings of exams. The interviews were conducted by six otolaryngologists, who applied the specific questionnaire, over the phone. Results: A total of 13,910 patients underwent telemonitoring, and 627 (4.51%) had olfactory loss complaints. Out of them, 330 were included in the survey. We observed a higher prevalence of altered smell in women (67%), and in patients aged under 50 years (86%). In most cases the manifestations had a sudden onset (70%), and in the first 5 days of illness (80%). The most prevalent associated symptom was a change in taste (89%), and only 2.7% of interviewed patients required hospitalization. Conclusion: Anosmia in COVID-19 is more prevalent in females and individuals aged under 50 years. It is a relevant initial symptom predictive of the disease, together with dysgeusia.

Chronic Maxillary Atelectasis (CMA) and Silent Sinus Syndrome (SSS) are conditions that may lie on the same clinical spectrum, since both have similarities in pathophysiology, clinical findings and treatment, although the absence of sinonasal symptoms is the main difference between them. In this study we present three different cases of CMA that were submitted to functional endoscopic sinus surgery to exemplify this condition and we made a literature review about both CMA and SSS for the most relevant and recent data about the subject. Most studies show that a negative pressure gradient may be the cause for the maxillary antral collapse and that best treatment is the endoscopic approach to reopen the sinus and restore its ventilation, orbital floor reconstruction is still debatable though. In conclusion, the understanding about both CMA and SSS seem to be increasing in the last years and that allows a better treatment and classification of the these conditions.