Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006

Sultész, Mónika; Csákányi, Zsuzsanna; Majoros, Tatjana; Farkas, Zsolt; Katona, Gábor

doi:10.1016/j.ijporl.2009.04.027

Cited by 67 publications

(51 citation statements)

References 11 publications

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“…Conservative treatment, which included oral or intravenous antibiotics in combination with topical decongestants or mucus thinning agents, was the first option for the inflammatory edema and orbital cellulitis in our study (7). However, ESS should be performed immediately for patients with orbital cellulitis concomitant optic neuritis, decreased vision or motility disorders of the eyeball (12).…”

Section: Discussionmentioning

confidence: 90%

Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

Wan¹,

Shi²,

Wang³

2016

Balkan Med J

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Background:The orbital complications account for about 80% of all complications secondary to acute rhinosinusitis. If the treatment is not correct and in time, orbital complications could progress rapidly, leading to optic neuritis, cavernous sinus thrombophlebitis or life-threatening intracranial complications. Aims: To evaluate the therapeutic efficacy of conservative therapy for the patients with orbital cellulitis and endoscopic sinus surgery (ESS) performed on patients with subperiosteal abscess (SPA) secondary to acute rhinosinusitis in children. Study Design: Retrospective cross-sectional study. Methods: The retrospective study included 31 pediatric patients with orbital complications secondary to acute rhinosinusitis. In all cases, intensive treatment was initiated with a combination of oral or intravenous antibiotics, glucocorticoid and gelomyrtol forte after admission. ESS was performed if an improvement in the condition of patients did not occur after 48 hours. However, the patients with orbital SPA, motility disorders of eyeball or decreased vision received ESS immediately within 24 hours. Results: Sixteen patients were cured by conservative therapy and 15 patients by ESS. All of the signs and symptoms disappeared after conservative therapy or ESS. There were no recurrences within the follow-up period of 1 to 8 years. Conclusion: Conservative therapy is an effective method for patients with inflammatory edema and most cases of orbital cellulitis in children. SPA can be cured by ESS.

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Section: Discussionmentioning

confidence: 90%

Treatment of Orbital Complications Following Acute Rhinosinusitis in Children

Wan¹,

Shi²,

Wang³

2016

Balkan Med J

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“…The most common complication of acute sinusitis involves the orbit in children with ethmoid sinusitis who are younger than 5 years. [29][30][31] Orbital complications should be suspected when the child presents with a swollen eye, especially if accompanied by proptosis or impaired function of the extraocular muscles. Orbital complications of acute sinusitis have been divided into 5 categories: sympathetic effusion, subperiosteal abscess, orbital cellulitis, orbital abscess, and cavernous sinus thrombosis.…”

Section: Optionmentioning

confidence: 99%

Clinical Practice Guideline for the Diagnosis and Management of Acute Bacterial Sinusitis in Children Aged 1 to 18 Years

Wald,

Applegate,

Bordley

et al. 2013

Pediatrics

426

368

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OBJECTIVE: To update the American Academy of Pediatrics clinical practice guideline regarding the diagnosis and management of acute bacterial sinusitis in children and adolescents. METHODS: Analysis of the medical literature published since the last version of the guideline (2001). RESULTS: The diagnosis of acute bacterial sinusitis is made when a child with an acute upper respiratory tract infection (URI) presents with (1) persistent illness (nasal discharge [of any quality] or daytime cough or both lasting more than 10 days without improvement), (2) a worsening course (worsening or new onset of nasal discharge, daytime cough, or fever after initial improvement), or (3) severe onset (concurrent fever [temperature ≥39°C/102.2°F] and purulent nasal discharge for at least 3 consecutive days). Clinicians should not obtain imaging studies of any kind to distinguish acute bacterial sinusitis from viral URI, because they do not contribute to the diagnosis; however, a contrast-enhanced computed tomography scan of the paranasal sinuses should be obtained whenever a child is suspected of having orbital or central nervous system complications. The clinician should prescribe antibiotic therapy for acute bacterial sinusitis in children with severe onset or worsening course. The clinician should either prescribe antibiotic therapy or offer additional observation for 3 days to children with persistent illness. Amoxicillin with or without clavulanate is the first-line treatment of acute bacterial sinusitis. Clinicians should reassess initial management if there is either a caregiver report of worsening (progression of initial signs/symptoms or appearance of new signs/symptoms) or failure to improve within 72 hours of initial management. If the diagnosis of acute bacterial sinusitis is confirmed in a child with worsening symptoms or failure to improve, then clinicians may change the antibiotic therapy for the child initially managed with antibiotic or initiate antibiotic treatment of the child initially managed with observation. CONCLUSIONS: Changes in this revision include the addition of a clinical presentation designated as “worsening course,” an option to treat immediately or observe children with persistent symptoms for 3 days before treating, and a review of evidence indicating that imaging is not necessary in children with uncomplicated acute bacterial sinusitis.

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“…Orbital complications develop most often between 3 and 6 years of age, and intracranial complications are more frequent in adolescents 50,51 . The most common complication of acute rhinosinusitis is periorbital cellulitis.…”

Section: Complications Of Sinusitismentioning

confidence: 99%