Our Experience in the Management of Orbital Complications in Acute Rhinosinusitis

Sansa-Perna, Aina; Gras-Cabrerizo, Juan R.; Montserrat-Gili, Joan R.; Rodríguez-Álvarez, Fernando; Massegur-Solench, Humbert; Casasayas-Plass, Maria

doi:10.1016/j.otoeng.2019.11.002

Cited by 5 publications

(5 citation statements)

References 20 publications

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“…Ключевые слова: риносинусит, орбитальные осложнения, возраст, тяжесть _________________________________________________________________________________________________  INTRODUCTION Acute rhinosinusitis (ARS) is a common paediatric disease manifested by infl ammation of the nose and sinuses and usually follows a viral infection or allergic rhinitis and may be exacerbated by bacterial infection [1,2]. ARS is a rare condition that carries a risk of severe complications and even death [1,3]. The orbital complication of ARS is common among the naive paediatric population [3,4].…”

Section: резюме _____________________________________________________...mentioning

confidence: 99%

“…ARS is a rare condition that carries a risk of severe complications and even death [1,3]. The orbital complication of ARS is common among the naive paediatric population [3,4]. It usually results in the direct spread of infection, local thrombophlebitis and acute ethmoidal sinusitis, which is exacerbated in children due to immature immune systems and developmental anatomy [5].…”

Section: резюме _____________________________________________________...mentioning

confidence: 99%

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The Orbital Complications of Acute Rhinosinusitis in Pediatric Patients: Observational Study

Улашев¹,

Махмудова²,

Хушвакова³

2022

Оториноларингология. Восточная Европа

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Цель. Описание опыта орбитальных осложнений острого риносинусита в педиатрической популяции и выявление факторов риска, связанных с тяжестью заболевания.Материалы и методы. В данном ретроспективном исследовании оценивались клинические показатели 78 детей, госпитализированных по поводу орбитальных осложнений в период с 2005 по 2020 г. Для изучения демографических данных и клинических симптомов использовалась описательная статистика.Результаты. Несмотря на антибактериальную терапию на догоспитальном этапе среди пациентов наблюдались постсептальные орбитальные осложнения. Была обнаружена статистически значимая связь между возрастом пациентов при поступлении и тяжестью заболевания. Дети старше семи лет имели более тяжелые орбитальные осложнения и чаще нуждались в хирургическом вмешательстве (p<0,001).Выводы. В данном исследовании орбитальные осложнения II и III стадии при поступлении и старший возраст были наиболее важными факторами, определяющими неэффективность медикаментозного лечения. Дети старше семи лет с острым риносинуситом должны быть направлены к оториноларингологу для эффективного лечения и предупреждения орбитальных осложнений. Purpose. To describe the experience of orbital complications of ARS in the paediatric population and to identify risk factors associated with disease severity.Materials and methods. This retrospective analysis evaluated the clinical outcomes of 78 children hospitalised for orbital complications between 2005 and 2020. Descriptive statistics were used to examine demographic data and clinical symptoms.Results. Although all children were treated with antibiotics prior to hospitalisation, more than half of this cohort experienced post-septal orbital complications. A significant association was found between age at admission and severity of illness. Children over seven years of age had more severe orbital complications and were more likely to require surgical intervnetion (p<0.001).Conclusions. In this study, stage II and III orbital complications at admission and older age were the most important determinants of failure of medical treatment. Early referral to an otolaryngologist should be considered for children older than seven years with ARS in order to assure an effective treatment and avoid orbital complications.

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Section: резюме _____________________________________________________...mentioning

confidence: 99%

Section: резюме _____________________________________________________...mentioning

confidence: 99%

The Orbital Complications of Acute Rhinosinusitis in Pediatric Patients: Observational Study

Улашев¹,

Махмудова²,

Хушвакова³

2022

Оториноларингология. Восточная Европа

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“…Studies about complications from ABRS included 309 patients that, according to the five-tiered Chandler's classification [32], were divided as follows: 114 preseptal cellulitis (stage I), 46 postseptal cellulitis (stage II), 74 subperiosteal orbital abscesses (SPOA, stage III), 20 orbital abscesses (stage IV) and 49 cavernous sinus thrombophlebitis (CST, stage V) [33][34][35][36][37][38][39][40][41][42]. In addition, 19 patients (8.41%) presented at the otorhinolaryngology department with a concomitant intracranial complication: 10 cerebral abscesses, 4 cerebral infarctions, 2 epidural abscesses, 2 subdural empyemas, and 1 case of meningitis (Table 2).…”

Section: • Abrsmentioning

confidence: 99%

Current Role of Non-Elective Transnasal Endoscopic Surgery: our Experience and Review of The Literature

2022

J Surg

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Background: in the last 30 years Trans-Nasal Endoscopic Surgery (TNES) has emerged as the mainstay of the elective treatment of most pathologies arising from sinonasal cavities. Growing technology and techniques made TNES an essential instrument even in the emergency/urgency scenario.Materials and Methods: a retrospective cohort analysis was conducted at our tertiary care center including patients who required TNES within 48 hours from their admission at the Emergency Department. Demographic characteristics and surgical outcomes were evaluated for patients treated from 1st January 2016 and 31th December 2020. Moreover, we reviewed the most recent literature about safety and efficacy of non-elective TNES in the management of the commonest otorhinolaryngology emergencies: epistaxis, acute bacterial rhinosinusitis, acute invasive fungal rhinosinusitis, and post-traumatic optic neuropathy.Results: on the whole, we performed non-elective TNES in 45 patients, with a success and a complication rate of 93.3% and 0.0%, respectively. 11.1% of patients reported long-term sequelae related to their primary disease, in spite of treatment. No deaths were perioperatively reported. 52 studies about non-elective TNES were included in the present paper, each encompassing one single disease. Conclusion:the specific competences acquired by otorhinolaryngologists made TNES a safe and efficacious procedure even in the treatment of non-elective sinonasal diseases. The importance of a well-trained multidisciplinary team came to light for a prompt and correct management of sinonasal conditions that are barely rare but potentially sight-and life-threatening.

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“…1,2 Although ARS is a rare disorder, it is regularly associated with higher severity of complications. 1,3 The orbital complication of ARS is relatively common in the pediatric age group. 3,4 Orbital complications tend to progress rapidly, leading to optical impairment, thrombophlebitis of paranasal sinuses, and serious intracranial complications.…”

Section: Introductionmentioning

confidence: 99%

“…1,3 The orbital complication of ARS is relatively common in the pediatric age group. 3,4 Orbital complications tend to progress rapidly, leading to optical impairment, thrombophlebitis of paranasal sinuses, and serious intracranial complications. 5 Infection spreading into the post septal space poses a significant risk of complications such as irreversible vision loss, brain abscess, cavernous thrombosis, and negative consequences such as prolonged hospitalization and antibiotic therapy, as well as the need for surgery.…”

Section: Introductionmentioning

confidence: 99%

Determinants of treatment outcomes in pediatric patients with acute rhinosinusitis caused orbital complications: observational study

Ulashev

Mahmudova²,

Khushvakova³

et al. 2022

Int J Otorhinolaryngol Head Neck Surg

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Background: The aim of the study was to identify predictors of disease severity and describe the characteristics of orbital complications as the direct result of ARS in children.Methods: Through retrospective study, we investigated 78 children with stage I-IV orbital complications between 2005 and 2020 in regional multidisciplinary children's medical center. Samples were obtained for the microbiological analyses. Statistical tests and descriptive statistical methods were used.Results: The research included 78 children who were hospitalized for orbital complications after ARS. There were 44 male patients (56.4%), with a sex ratio of 1.29:1. Staphylococcus aureus was cultured in 31 (34.8%) of patients, followed by Streptococcus pyogenes in 26 (29.2%). We found a significant association between age, severity of complications and treatment outcomes. The age of over seven years was associated with more severe orbital complications (stage II-III) and the need of surgical intervention (p<0.001). Pre-clinical antibiotic administration had no significant influence on illness severity at the time of presentation (p=0.38).Conclusions: In this study, severe orbital complications and the age of over seven years were determinants the antibiotic failure. Clinicians should consider early referral of children older than seven years with orbital complications for better treatment outcomes.

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Our Experience in the Management of Orbital Complications in Acute Rhinosinusitis

Cited by 5 publications

References 20 publications

The Orbital Complications of Acute Rhinosinusitis in Pediatric Patients: Observational Study

The Orbital Complications of Acute Rhinosinusitis in Pediatric Patients: Observational Study

Current Role of Non-Elective Transnasal Endoscopic Surgery: our Experience and Review of The Literature

Determinants of treatment outcomes in pediatric patients with acute rhinosinusitis caused orbital complications: observational study

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