Clinical presentation and outcome of the orbital complications due to acute infective rhino sinusitis

Indian J Otolaryngol Head Neck Surg. 2013 Aug;65(Suppl 2):431-4. doi: 10.1007/s12070-013-0646-6. Epub 2013 Mar 24.

Abstract

To describe the clinical presentation and visual outcome of patients with orbital complications of acute infective rhino sinusitis. This is a retrospective case series of patients diagnosed with of orbital involvement due to acute infective rhino sinusitis, who presented to eye OPD between July 2007 and July 2009. The medical records were reviewed with particular emphasis on clinical presentation and management. Twelve patients with an average age of 40.3 years (range, 14-65 years) were studied. The most common presentating symptom was diminution of vision (66.6 %) followed by proptosis, ptosis (33.3 %) and globe displacement (16.6 %). The most common orbital complication noted was orbital cellulitis (83.3 %). Majority of the patients had multiple sinus involvement. Ethmoid sinus was the most common sinus involved (91.6 %). Surgical intervention was required in 75 % of patients. Three patients (25 %) were managed conservatively by intravenous antibiotics. This series highlights the risk of orbital involvement and visual loss in patients with para nasal sinusitis. Early diagnosis, aggressive medical and prompt surgical treatment by multidisciplinary approach can successfully treat the complications.

Keywords: Acute rhino sinusitis; Orbital cellulitis; Paranasal sinuses; Visual loss.