Rhinogenic orbital complications of acute rhinosinusitis in children

Abstract

Purpose - to determine the frequency and prevalence of rhinogenic orbital complications (RОC) in children with acute rhinosinusitis (ARS) depending on their gender and age, with an analysis of the treatment performed in the pediatric ENT department. Materials and methods. A retrospective analysis of 61 patients with ROС at АRS in children who were treated in the otorhinolaryngology department of the City Children’s Hospital No. 1 in Kyiv from 2016 to 2020 was conducted. The diagnosis was established on the basis of the anamnesis, general clinical examination, endoscopic examination and radiological methods of diagnosis (X-rays or CT of paranasal sinuses). All patients received complex treatment with a parenteral antibiotic and were examined by related specialists: an ophthalmologist, a pediatrician, a neurologist or a neurosurgeon as needed. Results. The average age of the patients was 5 years and 2 months. There were 34 (55.7%) boys, 27 (44.3%) girls. In 38 (62.3%) sick children, reactive swelling of the eyelids of the right eye was diagnosed, in 22 (36.1%) reactive swelling of the eyelids of the left eye, in one (1.6%) case, periostitis of the right orbit was diagnosed. All patients with ROС on the background of АRS received parenteral antibacterial therapy with one or two drugs, among which ceftriaxone was prescribed in 98.3%, metrogyl in 41%, macrolide in 21.3%, and amoxicillin in 1.6% of cases. 3 (5%) patients underwent surgical treatment - puncture and drainage of the maxillary sinus, 2 (3.7%) sick children underwent frontotomy with sinus drainage. Complex conservative treatment without surgical intervention was effective in 56 (91.3%) patients. The average length of hospital stay was 7.7 days. Conclusions. In children with АRS, ROС occurs most often at the age of 3 to 7 years (49.2%) and manifests itself in the form of reactive swelling of the eyelids of the right eye in 62.3% and in 36.3% of the left eye. Timely antibiotic therapy in patients with АRS of children with ROС makes it possible to effectively treat this pathology without the use of surgical methods. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors.