Medical Treatment for Orbital Complications Secondary to Rhinosinusitis

Abstract

Background: Despite the modern antibiotherapies applied in the practice of otorhinology, the orbital complications of sinusitis are still considered a serious threat to essential functions of the eye, including loss of vision and life threatening symptoms. Aim. To assess the efficiency of medical treatment in orbital complications secondary to rhinosinusitis. Methods: Quasi-experimental study was admonished among 30 patients with orbital complications secondary to rhinosinusitis from January 2010-June 2017, at OtoRhinoLaryngoloy, Head & Neck Department, at Al-Thowrah general modern hospital, Sana'a, Yemen. All patients underwent to clinical examination, radiological investigations (C T, MRI), and initially aggressive medical treatment by IV. Antibiotic and locally nasal decongestant for 24-48 hours, if there is no evidence of improvement, we intervened with a surgical procedure, by nasal endoscopy or external approach in the form of external ethmoidectomy to evacuate collection of pus. Results: A total of 30 patients had complained of orbital complications secondary to rhinosinusitis were included in the study. Age ranged 2-50 year, males (73.3%) and females (26.7%) Patients. Children were the most category affected 24 patients, right was more than left side ethmoidal sinus was the most sinus affected, followed by ethmoid and maxillary sinuses together. Preseptal celullitis was the commonest complication (53.3%) patients, orbital celullitis, and subperiosteal abscess occurred in (20%) patients respectively. Medical treatment successes in (80%) patients, surgical procedure under covering of antibiotic was done in (20%) patients. Conclusion: Orbital complications were the most common complications secondary to rhinosinusitis and were more in the children. The outcome of the treatment depended on the types of complications. Medical treatment was showed high efficiency rate.