[Treatment of acute ethmoiditis according to a protocol based on clinical stage]. / Behandeling van acute etmoïditis volgens een protocol gebaseerd op het klinische stadium.

OBJECTIVE: To describe the results of application of a systematic treatment protocol, meant to reduce the risk of serious complications, when treating acute ethmoiditis. DESIGN: Prospective study. SETTING: Academic hospital of the 'Vrije Universiteit (VU)', Amsterdam, The Netherlands. METHOD: From January 1988 to March 1994, 25 children with acute ethmoiditis were admitted to the VU hospital. Eight of them had Chandler stage I, 8 stage II, 3 stage III, 3 stage IV and 3 stage V. The treatment protocol was stepwise, based on the Chandler stages and focused on intensive antibiotic treatment in combination with surgical drainage of the ethmoid complex and (or) the orbit. RESULTS: All children with ethmoiditis stages I-III were cured without rest symptoms. One patient with ethmoiditis stage IV and a pre-existent lymphatic leukaemia died of pulmonary complications of a massive fungal infection, 8 months after treatment. One patient with ethmoiditis stage V finally had permanent psychomotor retardation. CONCLUSION: The used treatment protocol offered the possibility to treat patients with acute ethmoiditis stepwise, depending on stage, with satisfying results. Especially the treatment result in patients with ethmoiditis stage V was good.