ABSTRACT
BACKGROUND: Orbital and periorbital complications due to acute paranasal sinusitis can be treated surgically or conservatively. In many cases the type of treatment depends on the ophthalmological findings. In the context of this clinical analysis we explored whether a conservative rather than an surgical therapy should be chosen for specific otorhinolaryngological or ophthalmological findings. METHODS: 32 patients were treated conservatively, whereas 4 patients had to be operated. Before therapy and after completion of the treatment otorhinolaryngologistical and ophthalmological findings were recorded and these findings as well as the two therapy options were compared with each other. RESULTS: In the cases of the 32 conservatively treated patients plus the 4 patients, who were treated surgically, a complete restitutio ad integrum could be observed at the end of the treatment period. DISCUSSION: A conservative therapy is obsolete in cases with specific ophthalmological findings such as reduction of vision, significant increase of exophthalmos, extreme limitation of motility. In all other cases, a conservative attempt can be made first, because the results of this therapy are as good as the results of surgical intervention but with less exposure for the patient. So the choice of therapy depends the ophthalmological findings.
