Orbital Complications of Sinusitis: A Retrospective Clinical Analysis

ABSTRACT

BACKGROUND AND OBJECTIVES: Sinusitis is frequently accompanied by severe orbital or intracranial complication which require a fast multidisciplinary therapy because a diagnostic delay may cause the patient's sequeles. We aim to evaluate the clinical features, radiologic findings, disease courses and therapy of sinogenic orbital complication. MATERIALS AND METHODS: We retrospectively reviewed the medical records of 34 patients with sinogenic orbital complications from January, 2002 to December, 2007. The clinical features of the complication, the radiologic findings, admission duration and treatment given to the patients were evaluated. The prognosis of each case was set according to the Chandler's classification. RESULTS: Periorbital cellulitis is the most common complication and it is found more frequently in children (54.5%) than in adult (21.7%). The most common symptom of sinogenic orbital complication is periorbital edema. In addition, facial and orbital pain is a common symptom. We identified the frequency of involved sinus in sinogenic orbital complications as follows;maxillary sinus (85.3%), anterior ethmoid sinus (82.4%), posterior ethmoid sinus (64.7%), frontal sinus (50.0%) and sphenoid sinus (35.3%). In terms of treatment, endoscopic surgery was needed in most cases except for periorbital cellulitis. CONCLUSION: Rhinosinusitis patients who have headache and ocular pain in spite of medical treatment need to consider the possibility of sinogenic complications. And early diagnosis and adequate treatment are important to prevent severe orbital complications.