Orbital Complications of Pediatric Sinusitis: Treatment of Periorbital Abscess

1997 ◽  
Vol 11 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Wolf Mann ◽  
Ronald G. Amedee ◽  
Jan Maurer
Keyword(s):  
Surgical Intervention ◽  
Acute Sinusitis ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Endonasal Surgery ◽  
Surgical Failure ◽  
Pediatric Sinusitis ◽  
Orbital Complications ◽  
Drainage Analysis

Twenty-six children requiring surgical intervention for orbital complications of acute sinusitis were treated at our institutions between 1985 and 1995. Twenty patients were successfully treated surgically utilizing endoscopic/microscopic endonasal surgery, or traditional external ethmoidectomy. However, six patients failed to respond to initial surgical attempts and ultimately required a revision. In one of these six patients the development of an intracranial abscess also necessitated a craniotomy for surgical drainage. Analysis of these six failures was performed with special attention given to the reasons for initial surgical failure and possible means for preventing revision surgeries.

The Groote Schuur hospital classification of the orbital complications of sinusitis

1997 ◽  
Vol 111 (8) ◽  
pp. 719-723 ◽  
Author(s):  
S. Mortimore ◽  
P. J. Wormald
Keyword(s):  
Computed Tomography ◽  
Relative Frequency ◽  
Surgical Intervention ◽  
Acute Sinusitis ◽  
High Resolution Computed Tomography ◽  
Septal Group ◽  
Ready Availability ◽  
Clear Differentiation ◽  
Orbital Complications

AbstractThe complications of sinusitis have been well described. The most common classifications used for orbital complications have been that of Chandler et al. (1970) and Moloney et al. (1987). With the ready availability of high-resolution computed tomography (CT) scanners, limitations of these classifications have become apparent. The aims of this study were to determine the relative frequency of the various complications associated with acute sinusitis, to determine which groups of sinuses were most frequently involved and to correlate the orbital signs with a new proposed classification of orbital complications. Over a five-year period, 87 consecutive patients were admitted with acute sinusitis. Sixty-three patients (72.4 per cent) had one or more complications. When orbital complications were classified under the proposed classification, all patients with proptosis and/or decreased eye movement had post-septal infection. Visual impairment occurred only in the post-septal group. Most complications had a combination of sinus involvement with the maxillary/ethmoid/frontal combination being the most common. The authors propose a modification of Moloney's classification for orbital complications of acute sinusitis that allows a clear differentiation between pre- and post-septal infection and a radiological differentiation to be made between cellulitis/phlegmon and abscess formation. The latter is of importance when a decision is made on whether surgical intervention is appropriate or not.

Orbital Complications of Acute Sinusitis: Evaluation, Management, and Outcome

1978 ◽  
Vol 86 (2) ◽  
pp. ORL-221-ORL-230 ◽  
Author(s):  
Victor L. Schramm ◽  
Eugene N. Myers ◽  
John S. Kennerdell
Keyword(s):  
Antibiotic Therapy ◽  
Surgical Intervention ◽  
Clinical Course ◽  
Age Groups ◽  
Orbital Cellulitis ◽  
Acute Sinusitis ◽  
Study Population ◽  
Orbital Complications

Acute orbital cellulitis is most commonly caused by sinusitis. This complication is based on the anatomy of the sinuses, orbit, and their venous connections. A series of 134 patients is reviewed to demonstrate the etiology and clinical course of orbital cellulitis. Antibiotic therapy alone does not prevent permanent complications. Surgical intervention is found necessary in all age groups and is required in 20% of the study population.

scholarly journals MEAN 6 YEAR CLINICAL OUTCOMES, SURVIVORSHIP, AND RETURN TO SPORTS AFTER ARTHROSCOPIC CAPSULAR REPAIR WITH SUTURE ANCHORS FOR ADOLESCENT MULTIDIRECTIONAL SHOULDER INSTABILITY

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0002
Author(s):  
Brendon C. Mitchell ◽  
Matthew Y. Siow ◽  
Alyssa Carrol ◽  
Andrew T. Pennock ◽  
Eric W. Edmonds
Keyword(s):  
Risk Factors ◽  
Surgical Treatment ◽  
Shoulder Instability ◽  
Surgical Intervention ◽  
Operation Time ◽  
Demographic Variables ◽  
Return To Sports ◽  
Suture Anchors ◽  
Surgical Failure

Background: Multidirectional shoulder instability (MDI) refractory to rehabilitation can be treated with arthroscopic capsulolabral reconstruction with suture anchors. No studies have reported on outcomes or examined the risk factors that may contribute to poor outcomes in adolescent athletes. Hypothesis/Purpose: To identify risk factors for surgical failure by comparing anatomic, clinical, and demographic variables in adolescents who underwent surgical intervention for MDI. Methods: All patients undergoing arthroscopic shoulder surgery at one institution between January 2009 and April 2017 were reviewed. Patients >20 years old at presentation were excluded. Multidirectional instability was defined by positive drive-through sign on arthroscopy plus positive sulcus sign and/or multidirectional laxity on anterior and posterior drawer testing while under anesthesia. Two-year minimum follow-up was required, but those whose treatment failed earlier were included for reporting purposes. Demographics and intraoperative findings were recorded, as were Single Assessment Numeric Evaluation (SANE) scoring, Pediatric and Adolescent Shoulder Survey (PASS), and the short version of the Disabilities of the Arm, Shoulder and Hand (QuickDASH) results. Results: Eighty adolescents (88 shoulders) were identified for having undergone surgical treatment of MDI. Of these 80 patients, 42 (50 shoulders; 31 female, 19 male) were available at a minimum of 2-year follow-up. Mean follow-up was 6.3 years (range, 2.8-10.2 years). Thirteen (26.0%) shoulders experienced surgical failure defined by recurrence of subluxation and instability, all of which underwent re-operation. Time to re-operation occurred at a mean of 1.9 years (range, 0.8-3.2). Our cohort had an overall survivorship of 96% at 1 year after surgery and 76% at 3 years. None of the anatomic, clinical, or demographic variables tested, or the presence of generalized ligamentous laxity, were correlated with subjective outcomes or re-operation. Number of anchors used was not different between those that failed and those that did not fail. Patients reported a mean SANE score of 83.3, PASS score of 85.0, and QuickDASH score of 6.8. Return to prior level of sport (RTS) occurred in 56% of patients. Conclusion: Multidirectional shoulder instability is a complex disorder that can be challenging to treat. Adolescent MDI that is refractory to non-surgical management appears to have long-term outcomes after surgical intervention that are comparable to adolescent patients with unidirectional instability. In patients who do experience failure of capsulorraphy, we show that failure will most likely occur within 3 years of the index surgical treatment. [Table: see text][Figure: see text]

Frontal Sinus Drainage in Acute Pediatric Sinusitis With Intracranial Complications

2021 ◽  
pp. 194589242199131
Author(s):  
Stephen R. Chorney ◽  
Adva Buzi ◽  
Mark D. Rizzi
Keyword(s):  
Surgical Procedures ◽  
Frontal Sinus ◽  
Case Series ◽  
Primary Objective ◽  
Acute Sinusitis ◽  
Intracranial Abscess ◽  
Repeat Surgery ◽  
Initial Surgery ◽  
Intracranial Complications ◽  
Sinus Drainage

Background The indication for frontal sinus drainage is uncertain when managing pediatric acute sinusitis with intracranial complications. Objective The primary objective was to determine if addressing the frontal sinus reduced need for subsequent surgical procedures in children presenting with acute sinusitis complicated by intracranial abscess. Methods A case series with chart review was performed at a tertiary children’s hospital between 2007 and 2019. Children under 18 years of age requiring surgery for complicated acute sinusitis that included the frontal sinus with noncontiguous intracranial abscess were included. Outcomes were compared among children for whom the frontal sinus was drained endoscopically, opened intracranially, or left undrained. Results Thirty-five children with a mean age of 11.1 years (95% CI: 9.9-12.3) met inclusion. Most presented with epidural abscess (37%). Hospitalizations lasted 12.9 days (95% CI: 10.2-15.5), 46% required a second surgery, 11% required three or more surgeries, and 31% were readmitted within 60 days. Initial surgery for 29% included endoscopic frontal sinusotomy, 34% had a frontal sinus cranialization and 37% did not have any initial drainage of the frontal sinus. Groups were similar with respect to demographics, severity of infection, need for repeat surgery, length of stay, and readmissions (p > .05). Further, persistence of cranial neuropathies, seizures, or major neurological sequelae after discharge were no different among groups (p > .05). Conclusion Drainage of the frontal sinus, when technically feasible, was not associated with reduced surgical procedures or increased complications and there is unclear benefit on measured clinical outcomes.

Orbital complications of acute sinusitis

2017 ◽  
Vol 28 (4) ◽  
pp. 213-219 ◽  
Author(s):  
Adam P. Campbell ◽  
Regan W. Bergmark ◽  
Ralph Metson
Keyword(s):  
Acute Sinusitis ◽  
Orbital Complications

Letters to the Editor

PEDIATRICS ◽  
1981 ◽  
Vol 68 (3) ◽  
pp. 465-466
Author(s):  
Itzhak Brook
Keyword(s):  
Antimicrobial Therapy ◽  
Surgical Drainage ◽  
Intracranial Abscess ◽  
Letters To The Editor ◽  
Ample Evidence ◽  
Complete Cure ◽  
Intracranial Complications

There is ample evidence to indicate that administration of antimicrobial therapy alone to patients with intracranial abscess can result in neurologic deterioration1 and higher mortality.2 In our article entitled "Complications of Sinusitis in Children" we described the occurrence of intracranial complications following sinusitis.3 Surgical drainage accompanied by antimicrobial therapy resulted, eventually, in complete cure of all of our patients. However, three out of four of our patients with intracranial abscess initially did not respond to appropriate antimicrobial therapy directed against the organisms recovered from their abscesses.

scholarly journals Rupture of an infected iliac artery pseudoaneurysm caused by asymptomatic gastrointestinal foreign body perforation

2020 ◽  
Vol 48 (7) ◽  
pp. 030006052094208 ◽  
Author(s):  
Yu Lun ◽  
Han Jiang ◽  
Shijie Xin ◽  
Jian Zhang
Keyword(s):  
Foreign Body ◽  
Iliac Artery ◽  
Surgical Intervention ◽  
Abscess Formation ◽  
Retroperitoneal Abscess ◽  
Surgical Drainage ◽  
Unique Case ◽  
Artery Pseudoaneurysm ◽  
Infected Pseudoaneurysm ◽  
Iliac Artery Pseudoaneurysm

We report a unique case of a ruptured iliac artery pseudoaneurysm caused by asymptomatic gastrointestinal perforation and retroperitoneal abscess formation. A 46-year-old man presented to the Emergency Department of our institution. Angiography showed a ruptured iliac artery pseudoaneurysm caused by retroperitoneal abscess formation. After endovascular repair and surgical drainage, the cause of the abscess was finally identified as a toothpick. Findings from this case show that asymptomatic gastrointestinal foreign body perforation can be a rare, but insidious, cause of an infected pseudoaneurysm. Prompt surgical intervention is sometimes necessary when treating patients with arterial pseudoaneurysm caused by a perivascular abscess.

Intracranial and Orbital Complications of Sinusitis: A Case Series and Review of Literature

2011 ◽  
Vol 4 (2) ◽  
pp. 87-92 ◽  
Author(s):  
Kishore Shetty ◽  
Vinay Vaidyanathan
Keyword(s):  
Surgical Intervention ◽  
Case Series ◽  
Interesting Case ◽  
Sinus Surgery ◽  
Intracranial Extension ◽  
Review Of Literature ◽  
Neurosurgical Technique ◽  
Orbital Complications ◽  
Late Recognition

ABSTRACT Complications of paranasal sinus infection most often involve the orbit and periorbita. Because of widespread use of antibiotics, intracranial extension of paranasal sinusitis is rarely seen today. Nevertheless, the clinician must be aware of the potential of these complications, as late recognition of this condition and delay in treatment can increase morbidity and mortality rates. An interesting case series of sinusitis with orbital and intracranial complication is presented, which was radiologically evaluated, and was managed by endoscopic sinus surgery with drainage of subdural empyema by appropriate neurosurgical technique. The radiological tools played a very important role in both assessment and timing of surgical intervention. Unparallel role of radiological investigations cannot be overemphasized. The key to successful treatment is aggressive management and the timing for surgical intervention should not be deferred. The patients made full recovery at the time of discharge.

scholarly journals Acute Sinusitis in Children - A retrospective study of orbital complications

2007 ◽  
Vol 73 (1) ◽  
pp. 75-79 ◽  
Author(s):  
Levon Mekhitarian Neto ◽  
Shirley Pignatari ◽  
Sérgio Mitsuda ◽  
Antonio Sérgio Fava ◽  
Aldo Stamm
Keyword(s):  
Retrospective Study ◽  
Acute Sinusitis ◽  
Orbital Complications

Failure of contrast enhanced computed tomography scans to identify an orbital abscess. The benefit of magnetic resonance imaging

2007 ◽  
Vol 122 (6) ◽  
pp. 639-640 ◽  
Author(s):  
D Mcintosh ◽  
M Mahadevan
Keyword(s):  
Magnetic Resonance Imaging ◽  
Computed Tomography ◽  
Magnetic Resonance ◽  
Imaging Techniques ◽  
Acute Sinusitis ◽  
Illustrative Case ◽  
Resonance Imaging ◽  
Computed Tomography Scanning ◽  
Enhanced Computed Tomography ◽  
Orbital Complications

AbstractIntroduction:Acute sinusitis is a relatively common condition, which usually responds to medical therapy. In most cases, there are no sequelae or complications subsequent to this infection. However, like many acute illnesses, there are well documented complications of acute sinusitis, and in particular these include peri-orbital and intracranial spread.Objective:The purpose of this paper is to highlight the importance of vigilance in peri-orbital involvement and the limitations of imaging techniques, such as computed tomography scanning. An illustrative case is presented to demonstrate this.Conclusion:Magnetic resonance imaging scanning is a valuable modality in assessing complex presentations of peri-orbital complications of acute sinusitis.

Sign in / Sign up

Export Citation Format

Share Document