Trends in Orbital Complications of Pediatric Rhinosinusitis in the United States

Capra, Gregory; Liming, Bryan J.; Boseley, Mark E.; Brigger, Matthew T.

doi:10.1001/jamaoto.2014.2626

Cited by 37 publications

(25 citation statements)

References 25 publications

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“…Additionally, 25% of patients in our study with orbital complications underwent sinus procedures, in agreement with previous data showing increasing rates of surgical intervention in management of orbital complications of sinusitis. 6 As expected, our data corroborated that total LOS and THC were higher in patients undergoing sinus procedures than those who did not. 7,15 We felt comparison of LOS after surgery for those undergoing procedures with total LOS for those who did not was a more meaningful comparison of LOS associated with each treatment modality.…”

Section: Discussionsupporting

confidence: 88%

Impact of Sinus Surgery on Hospital Utilization for Complications of Sinusitis

Pandrangi

Reiter

2019

Ear Nose Throat J

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Background: Sinusitis complications are potentially lethal conditions that generally require extensive treatment and thus place a significant burden on the health-care system. The purpose of this study was to assess the impact of surgery on hospital utilization associated with treatment of sinusitis complications. Methods: Retrospective cohort study using a national hospital database. The 2012 to 2013 National Inpatient Sample was queried for adult patients with sinusitis and complications. Patients were grouped based upon the presence or absence of sinus procedures. Patient demographics and health status, hospital characteristics, length of stay (LOS), and charges were determined. Results: Of 1645 patients with sinusitis and associated complications, 232 (14%) underwent sinus procedures. These patients had higher LOS (8.0 + 7.3 days vs 4.3 + 5.2 days; P < .001) and charges (US$96 107 + 108 089 vs US$30 661 + 47 138; P < .001) than nonprocedure patients. Increased time to procedure in one operation patients (n ¼ 209) of more than 2 days increased total LOS (11.4 + 9.3 days vs 6.2 + 5.5 days; P < .001) and charges (US$120 306 + 112 748 vs US$76 923 + 81 185; P ¼ .005). Patients with multiple sinus procedures (n ¼ 23) versus one had increased LOS and charges, despite no time difference from admission to first procedure (P ¼ .35). On regression analysis, sinus procedure patients had excess LOS of 0.827 days and charges of US$36 949. Conclusion: Although often necessary, sinus procedures lead to increased LOS and charges. As prolonged time to sinus procedure and revision operations also increase charges, shorter trials of medical therapy and earlier surgical intervention may improve outcomes and reduce costs.

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Section: Discussionsupporting

confidence: 88%

Impact of Sinus Surgery on Hospital Utilization for Complications of Sinusitis

Pandrangi

Reiter

2019

Ear Nose Throat J

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“…Hence, the preventive treatment of complicated acute sinusitis must go through the management of viral rhinopharyngitis since they constitute the front door of sinusitis in most cases, and therefore that of complications. No study to date has investigated the role of vaccines through the general route in preventing the acute rhino-sinus infection of the child [32]. It is likely that the Hib conjugated vaccines (1992) and Heptavalent conjugated pneumococcus are induced by reducing the nasopharyngeal carriage of vaccine serotypes and their transmission, an individual but also collective protection [31] [33].…”

Section: Discussionmentioning

confidence: 99%

Oculo Orbital Complications of Sinusitis

Otmani¹,

Serheir²,

Sami³

et al. 2016

OJOph

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The ocular-orbital complications of sinusitis constitute a diagnostic and therapeutic urgency that requires a correct multidisciplinary assumption. Objectives: The description of clinical and therapeutic data of the orbital complications of acute sinusitis. Methods: Our work is based on a retrospective study of 86 cases of ocular-orbital complications of sinusitis hospitalized at the ENTdepartment of Hassan II Hospital in Fes (Morocco), between the years of 2006 and 2014. Results: It is about 56 men and 30 women. The average age was 24 years, with the extremes of 3 years and 65 years. The average time of consultation was 13 dates. The achievement was frontal-ethmoido in 26 cases, and it is about a pan sinusitis in 24 cases. About 13% and 7% of cases were classified respectively in the stage III and the stage IV of chandler. The surgery was done for 24 cases. Bacteriological sample was performed among 24 patients and allowed to isolate a streptococcus (3.5%), and a staphylococcus (5.8%), and a poly microbial flora for 15.1% of patients. A death in sepsis panel was noted for a patient who presented a thrombosis of cavernous sinus. And we have noted a persistent left exophthalmia without the diminution of visual acuity for another patient. Conclusion: The orbital complications of sinusitis require a multi-disciplinary medical approach associated to ear specialist, ophthalmologist, and neuro-radiology. A precocious diagnosis, an appropriate anti-biotic therapy, and sometimes an associated surgical treatment, can significantly diminish the mortality and the morbidity related to this pathology.

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“…Referral and evaluation by an otolaryngologist for any complicated sinus infection is indicated due to a potential for rapid progression of disease even with antibiotic therapy. However, it has been shown that even in the setting of a subperiosteal abscess (Chandler class III), successful treatment can be accomplished in 93 % of children with medical management alone [29,30]. Medical management is most successful for Chandler class I or early class II, but all pediatric patients with acute sinusitis with orbital involvement require close observation by an otolaryngologist for possible surgical drainage of the sinuses.…”

Section: Complications Of Acute Rhinosinusitismentioning

confidence: 99%