Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2019, Vol. 33 ›› Issue (6): 34-40.doi: 10.6040/j.issn.1673-3770.1.2019.062

Previous Articles     Next Articles

Clinical diagnosis and treatment of orbital complications following pediatric acute rhinosinusitis

ZHANG Chanyuan1, SUN Yulin2, WANG Lin1, ZHANG Li3, CHEN Min1, YI Longgang1, LI Na1, CUI Xin3, JIANG Yan1   

  1. Department of Otorhinolaryngology Head and Neck Surgery, Nasal Skull Base Surgery, The Affiliated Hospital of Qingdao University/Shandong Key Laboratory of Otorhinolaryngology Head and Neck Surgery, Qingdao 266003, Shandong, China;
  • Online:2019-11-20 Published:2019-12-23

PDF (PC)

512

Abstract: Objective To study the clinical features and therapeutic strategies for orbital complications of pediatric rhinosinusitis. Methods The clinical data of 31 children with orbital complications caused by sinusitis treated in the Department of Otorhinolaryngology Head and Neck Surgery from October 2010 onwards were retrospectively analyzed and summarized. Results The orbital complications of pediatric sinusitis have different stages, which correspond with clinical characteristics and imaging findings. All cases were cured and discharged from our hospital. No recurrence occurred during the follow-up period of 9 to 24 months. One case was left with an eyelid ectropion, and one with a saddle nose. No serious complications such as cavernous sinus suppurative inflammation or an intracranial infection occurred. The bacterial culture rate in the patients pus and nasal secretions was 55%, including 4 cases of Staphylococcus aureus and 4 of Streptococcus pneumoniae. Conclusions In children, orbital complications caused by sinusitis occur more often in winter and spring, and males. It is closely related to other upper respiratory tract infections. The primary symptoms are atypical resulting in delayed treatment. Adequate and sensitive antibiotics should be used to control any infection early. Cefoperazone sodium and sulbactam sodium are usually used for treating children with rhinogenic orbital complications. If conservative treatment is ineffective, the stage of the disease should be assessed along with any changes in clinical and imaging manifestations examined. Satisfactory results can be obtained according to surgical indications.

Key words: Sinusitis, Children, Orbital complications, Orbital cellulitis, Treatment

CLC Number: 

  • R725.6
[1] Al-Madani MV, Khatatbeh AE, Rawashdeh RZ, et al. The prevalence of orbital complications among children and adults with acute rhinosinusitis[J]. Braz J Otorhinolaryngol, 2013, 79(6):716-719. doi:10.5935/1808-8694.20130131.
[2] Meara DJ. Sinonasaldisease and orbital cellulitis in children[J]. Oral Maxillofac Surg Clin North Am, 2012, 24(3): 487-496. doi:10.1016/j.coms. 2012.05.002.
[3] 孙艳丽, 唐新业, 杨阳. 儿童急性鼻窦炎并发眶内感染的临床诊疗[J]. 检验医学与临床, 2017, 14(22): 3375-3376. doi:10.3969/j.issn.1672-9455.2017.22.036.
[4] 潘宏光, 李兰, 钟辉, 等. 儿童鼻源性眶蜂窝织炎诊疗分析[J]. 中华耳鼻咽喉头颈外科杂志, 2015, 50(1): 14-19. doi:10.3760/cma.j.issn.1673-0860. 2015.01.004. PAN Hongguang, LI Lan, ZHONG Hui, et al. Management of nasal orbital cellulitis in children[J]. Chinese Journalof Otorhinolaryngology Head and Neck Surgery, 2015, 50(1): 14-19. doi:10.3760/cma.j.issn.1673-0860. 2015.01.004.
[5] Youssef OH, Stefanyszyn MA, Bilyk JR. Odontogenic orbital cellulitis[J]. Ophthalmic Plast Reconstr Surg, 2008, 24(1): 29-35. doi:10.1097/IOP. 0b013e318160c950.
[6] 常青, 何俊霖, 俞立英, 等. 上海市静安区、闸北区人群牙周感染厌氧菌群分布及耐药性研究[J]. 中国临床医学, 2012, 19(4): 424-426. doi:10.3969/j.issn.1008-6358. 2012.04.035. CHANG Qing, HE Junlin, YU Liying, et al. Isolation and identification of anaerobes in periodontal abscess in different regions of Shanghai[J]. Chinese Journal of Clinical Medicine, 2012, 19(4): 424-426. doi:10.3969/j.issn.1008-6358. 2012.04.035.
[7] Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis[J]. Laryngoscope, 1970, 80(9): 1414-1428. doi:10.1288/00005537-197009000-00007.
[8] Brook I, Friedman EM, Rodriguez WJ, et al. Complications of sinusitis in children[J]. Pediatrics, 1980, 66(4): 568-572.
[9] Allan K, Atkinson H, Agada F. Posterior orbital cellulitis: case report and literature review[J]. J Laryngol Otol, 2013, 127(11): 1148-1151. doi:10.1017/S0022215113002181.
[10] 王飞, 王振常, 鲜军舫. 眼眶蜂窝织炎的CT、MR表现[J]. 临床放射学杂志, 2009, 28(5): 618-620. doi:10.13437/j.cnki.jcr. 2009.05.036. WANG Fei, WANG Zhenchang, XIAN Junfang. CT and MR findings of orbital cellulites[J]. Journal of Clinical Radiology, 2009, 28(5): 618-620. doi:10.13437/j.cnki.jcr. 2009.05.036.
[11] Patt BS, Manning SC. Blindness resulting from orbital complications of sinusitis[J]. Otolaryngol Head Neck Surg, 1991, 104(6): 789-795. doi:10.1177/019459989110400604.
[12] 祝青萍, 万玉柱. 儿童急性鼻窦炎眶并发症的临床表现及治疗[J]. 山东大学耳鼻喉眼学报, 2017, 31(1): 91-94. ZHU Qingping, WAN Yuzhu. Clinical manifestation and treatment of orbital complications following acute rhinosinusitis in children[J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2017, 31(1): 91-94.
[13] 于龙刚, 李娜, 姜彦, 等. 儿童急性鼻窦炎眶并发症五例临床分析[J]. 中华耳鼻咽喉头颈外科杂志, 2012, 47(4): 314-316. doi:10.3760/cma.j.issn.1673-0860. 2012.04.011. YU Longgang, LI Na, JIANG Yan, et al. Clinical analysis of orbital complications of acute pediatric sinusitis[J]. Chinese Journal of Otorhinolaryngology Head and Neck Surgery, 2012, 47(4): 314-316. doi:10.3760/cma.j.issn.1673-0860. 2012.04.011.
[14] Sultész M,Csákányi Z, Majoros T, et al. Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006[J]. Int J Pediatr Otorhinolaryngol, 2009, 73(11): 1507-1512. doi:10.1016/j.ijporl. 2009.04.027.
[15] 樊云葳, 吴倩, 曹文红, 等. 儿童眼眶蜂窝织炎(续)[J]. 中国斜视与小儿眼科杂志, 2014, 22(3): 48-48, 31.
[16] Beech T, Robinson A, Mcdermott AL, et al. Pediatric periorbital cellulitis and its management[J]. Rhinology, 2007, 45(1):47-49.
[1] LI Yong. The difficulties, challenges, and strategy for diagnosing and treating pediatric sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 1-7.
[2] XU Geng. CT scans should not be routinely used for diagnosing chronic sinusitis in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 8-9.
[3] YANG Yifan, CHENG Lei. Rhinosinusitis and asthma in children: united airway disease [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 10-15.
[4] LI Huabin, CAO Yujie. Diagnosis and treatment of pediatric rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 16-19.
[5] LI Yong. The role of antibiotics for pediatric sinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 20-24.
[6] ZHANG Liqiang. Relationship between sinusitis and adenoid hypertrophy in children [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 25-28.
[7] LIU Jia, FU Yong. Advances in the surgical treatment of pediatric patients with chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 29-33.
[8] ZHU Luping, CHEN Juan, ZHU Lei, CHEN Renjie. A child with acute rhinosinusitis, acute glomerulonephritis and an orbital abscess: case report [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(6): 41-44.
[9] Minghong SUN,Xian GAO,Ting ZHAO,Wenjun LIU. Comparison between the efficacy of nasal lavage and combination treatment in allergic rhinitis and vasomotor rhinitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 73-78.
[10] Taisheng CHEN, Wei WANG, Kaixu XU, Peng LIN. Thoughts on benign paroxysmal positional vertigo and its diagnosis and treatment [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 1-5.
[11] Chengcheng LIANG,Xin WANG,Dapeng LEI. Electronic nasopharyngoscopy for the diagnosis and treatment of otorhinolaryngologic diseases: A retrospective study of 27400 cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 107-110.
[12] Shujing HAN,Jie LU,Ping CHU,Lixing TANG,Huiwen ZHENG,Xiaojian YANG,Wei ZHANG,Pengpeng WANG,Jie ZHANG,Yongli GUO,Wentong GE. Meta analysis of the nasal cavity bacterial culture in chronic rhinosinusitis [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 132-138.
[13] Weihua CHEN,Kaiyang ZHANG,Xiaobin ZHENG. Foreign bodies in the throat and bronchi of children: a report of 221 cases [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 111-115.
[14] Zhaokun WU,Xinhua ZHU. Can adenotonsillectomy adequately cure children with obstructive sleep apnea syndrome [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 148-152.
[15] Chuanshuo LI,Yongtuan LI,Hainan CAO,Menglu ZHANG. Quantitative analysis of behavior pattern in vertiginous patients [J]. Journal of Otolaryngology and Ophthalmology of Shandong University, 2019, 33(5): 32-36.
Viewed
Full text


Abstract

Cited
  Shared   
  Discussed   
[1] YANG Changliang,HUANG Zhiwu,YAO Hangqi,ZHU Yong,SNU Yi . Study on auditory brainstem response[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 9 -13 .
[2] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2006, 20(1): 90 -91 .
[3] LIU Da-yu,PAN Xin-liang,LEI Da-peng,ZHANG Li-qiang,LUAN Xin-yong . Surgical treatment for medial wall pyriform sinus cancer[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2007, 21(1): 8 -11 .
[4] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(2): 188 -188 .
[5] LIU Yan,LIU Xin-yi,WANG Jin-ping,LI Da-jian . Measurement of the posterior tympanum and its clinical significance [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 218 -221 .
[6] ZHAO Min,WANG Shou-sen,ZHEN Ze-nian,CHEN Xian-ming,WANG Mao-xin . Sphenoid sinus and trans-sphenoid surgery under nasal endoscopy and microscopy [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 244 -245 .
[7] . [J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 252 -252 .
[8] WANG Hong-xia,WANG Peng-cheng . Expression of NSE,S100 and GFAP in retinoblastoma and its clinical significance[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 263 -264 .
[9] HUANG Fang,HUANG Hai-qiong,HUANG Jian-qiang,HE He-fan . Bronchoscopic video supervision system in infant bronchial foreign bodies[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 276 -277 .
[10] YU Zhi-liang,WANG Wei-wei,WANG Ming-hua . Excision of huge epiglottis cysts under MedtrnicXPS3000 in 23 cases[J]. JOURNAL OF SHANDONG UNIVERSITY (OTOLARYNGOLOGY AND OPHTHALMOLOGY), 2008, 22(3): 278 -279 .
Website Copyright: Editorial Office of Journal of Otolaryngology and Ophthalmology of Shandong University
Address: No.27 Shanda South Road, Jinan, Shandong, China. Post code: 250100 Tel: +86-0531-88366912 Email: ebhxb@sdu.edu.cn Supported by Beijing Magtech Co.Ltd