Functional Endoscopic Orbital Decompression Surgery in Acute Rhinosinusitis with Orbital Complication : A Case Report

Authors

  • Michael Lekatompessy Medicine Faculty of Pelita Harapan University
  • Amanda P Kirana Medicine Faculty of Pelita Harapan University

DOI:

https://doi.org/10.19166/med.v9i1.4197

Keywords:

acute rhinosinusitis, orbital complications

Abstract

Introduction: Orbital complications secondary to acute rhinosinusitis can cause permanent vision loss and death if not treated promptly and appropriately. The prevalence of orbital complications due to rhinosinusitis is more common in children than adults, occurring in 3-4% of children with acute rhinosinusitis. Lamina papyracea in children has many dehiscences, the nasal cavity tends to be narrower and the mucosa is softer than in adults, therefore causing the spread of infection more easily from the sinuses to the eyes. Clinical presentation: a 4-year-old child presented with eye swelling and pus discharge in the right eye for 5 days before being admitted to the hospital, for which she was treated with medication and did not improve. On physical examination, there is a narrow nasal cavity, inferior turbinate edema, and hyperemia, mucopurulent discharge. CT scan and MRI revealed contrast enhancement in intraorbital with suspected intraorbital abscess with orbital cellulitis, right pansinusitis, and buccal abscess. Functional endoscopic orbital decompression was done immediately.

Conclusion: Orbital complications due to acute rhinosinusitis are uncommon but potentially lead to more fatal complications. Early diagnosis and aggressive treatment of immediate functional endoscopic sinus surgery and antimicrobial therapy have a good outcome.

References

1. Singh SK, James E, Sabarigirish K, Swami H, Sood T. Bilateral orbital complications of pediatric rhinosinusitis. Med J Armed Forces India. 2014;70:68-72.
https://doi.org/10.1016/j.mjafi.2012.11.015

2. Torretta S, Guastella C, Marchisio P, Marom T, Bosis S, Ibba T, Drago L, Pignataro L. Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview. Journal of Clinical Medicine. 2019; 8(1):101. https://doi.org/10.3390/jcm8010101

3. Çelik M, Kaya KH, Yegin Y, Olgun B, Kayhan FT. Anatomical Factors in Children with Orbital Complications Due to Acute Rhinosinusitis. Iran J Otorhinolaryngol. 2019;31(106):289-295. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6764809/

4. Badr, D., Gaffin, J. and Phipatanakul. Pediatric Rhinosinusitis. 2017;4:268-281.
https://doi.org/10.1007/s40521-016-0096-y

5. Pradhan P, Samal DK, Preetam C, Parida PK. Intraorbital and intracranial complications of acute rhinosinusitis: A rare case report. Iran J Otorhinolaryngol. 2018;30:301-4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6147267/

6. Surgery AA of O-H and N. Diagnostic Criteria for Rhinosinusitis. Clin Pract Guidel AAO. 2015;12.

7. Wan, Y., Shi, G. and Wang, H. Treatment of Orbital Complications Following Acute Rhinosinusitis in Children. 2016;33:401-6.
https://doi.org/10.5152/balkanmedj.2016.141065

8. Drago L, Pignataro L, Torretta S. Microbiological Aspects of Acute and Chronic Pediatric Rhinosinusitis. J Clin Med. 2019;8:149.
https://doi.org/10.3390/jcm8020149

9. Chang YS, Chen PL, Hung JH, Chen HY, Lai CC, Ou CY, et al. Orbital complications of paranasal sinusitis in Taiwan, 1988 through 2015: Acute ophthalmological manifestations, diagnosis, and management. PLoS One. 2017;12:1-14.
https://doi.org/10.1371/journal.pone.0184477

10. Chow AW, Benninger MS, Brook I, Brozek JL, Goldstein EJC, Hicks LA, et al. IDSA GUIDELINES IDSA Clinical Practice Guideline for Acute Bacterial Rhinosinusitis in Children and Adults. 2012;54:1041-5.
https://doi.org/10.1093/cid/cir1043

11. Wan, Y., Shi, G. and Wang, H. Treatment of Orbital Complications Following Acute Rhinosinusitis in Children. 2016;33:401-6.
https://doi.org/10.5152/balkanmedj.2016.141065


Downloads

Published

2021-09-06

Issue

Section

Case Report