Can Initial Management of Paediatric Acute Rhinosinusitis With Orbital Complications Predict Future Outcomes? A Cohort Study

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-05-20 DOI:10.1111/coa.14329

Elchanan Zloczower, Itay Pansky, Batel Lasry, Aviad Sapir, Michael Samin, Itai Hazan, Lior Freidrich, Ofer Gluck, Oded Cohen, Oren Ziv

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引用次数: 0

Abstract

Background

Approximately 6%–8% of children diagnosed with acute rhinosinusitis (ARS) would experience complications, primarily periorbital or orbital complications (OC). Both conservative and surgical management have been shown to be successful, and the choice of proper management depends on the presentation and the surgeon's discretion. The objective of this study was to describe the long-term outcomes of each modality on future ARS episodes, with or without OC.

Methods

This retrospective study included patients < 16 years old with OC-ARS admitted to a tertiary hospital from 2002 to 2019. Patients were divided into groups based on treatment: conservative and surgical. Outcomes measured included recurrence of ARS, OC-ARS and future hospitalisations or surgeries due to ARS over a 5-year follow-up period.

Results

Among 213 children diagnosed with OC-ARS, 192 (90.1%) were treated conservatively and 21 (9.9%) surgically. Most surgeries were performed endoscopically (16/21, 76.2%). Surgically treated children were older and had significantly higher rates of proptosis, impaired eye movement and higher Chandler scores at presentation (p = 0.034, p < 0.001, p < 0.001, p < 0.001, respectively). Overall, recurrent ARS rates were 10.3%, with significantly higher rates in the surgical group compared with the conservative group (28.6% vs. 8.3%, p = 0.012). While the surgical group did not have a significantly shorter interval to recurrence compared with the conservative group (8 vs. 15 months, p = 0.8), a significant risk reduction over time was observed (OR 6.22 and 3.71 after 1 and 5 years, respectively, p < 0.005).

Conclusion

Most children with OC-ARS recover fully without future sequela. However, children that needed surgical treatment during the acute phase of OC-ARS, are at greater risk for future ARS episodes, particularly within the first-year post-surgery.

Abstract Image

查看原文本刊更多论文

小儿急性鼻窦炎伴眼窝并发症的初步治疗能否预测未来的预后？一项队列研究。

背景：大约6%-8%诊断为急性鼻窦炎（ARS）的儿童会出现并发症，主要是眼眶周围或眼眶并发症（OC）。保守治疗和手术治疗都是成功的，选择合适的治疗方法取决于临床表现和外科医生的判断力。本研究的目的是描述每种方式对未来ARS发作的长期结果，无论有无OC。结果：在213例确诊为OC-ARS的儿童中，192例（90.1%）采用保守治疗，21例（9.9%）采用手术治疗。大多数手术在内镜下进行（16/21,76.2%）。手术治疗的患儿年龄较大，眼球突出率、眼球运动受损率和就诊时的钱德勒评分明显较高（p = 0.034, p）。结论：大多数OC-ARS患儿完全康复，无后遗症。然而，在OC-ARS急性期需要手术治疗的儿童，未来发生ARS的风险更大，特别是在手术后的第一年。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.