Suhaili D N Pengiran, Goh B S, Gendeh B S
Department of Otorhinolarygology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre, Jalan Yaacob Latif, Cheras 56000 Kuala Lumpur, Malaysia.
Med J Malaysia. 2010 Mar;65(1):49-52.
Acute sinusitis is most often a mild self-limiting disease. However, it may progress into severe and life threatening complications. One of the commonest being orbital complication of which visual loss is a direct consequence. In this 10 year retrospective study, the nature of orbital complication, clinical presentation and treatment modalities and outcome seen in children with acute sinusitis in a tertiary referral institute were reviewed. Of six patients, there was a case of preseptal cellulitis, 4 cases of subperiosteal abscess and one case of orbital abscess. Periorbital swelling was a common presenting feature. In 5 cases this was associated with proptosis with one case of impending optic nerve compression. The value of computed tomography and opthalmological examination as a component in the management plan is highlighted. All patients were treated with intravenous antibiotics but evidence of abscess collection warranted urgent surgical drainage in 5 patients, 3 being endoscopic drainage while external approach was done for the remaining 2 patients. Thus a child exhibiting orbital complication of acute sinusitis, prompt diagnosis and treatment is essential in obtaining the best outcome for the child.
急性鼻窦炎通常是一种轻度的自限性疾病。然而,它可能会发展为严重的、危及生命的并发症。最常见的并发症之一是眼眶并发症,视力丧失是其直接后果。在这项为期10年的回顾性研究中,我们回顾了一家三级转诊机构中急性鼻窦炎患儿眼眶并发症的性质、临床表现、治疗方式及结果。6例患者中,有1例眶隔前蜂窝织炎、4例骨膜下脓肿和1例眼眶脓肿。眶周肿胀是常见的表现特征。5例伴有眼球突出,其中1例有视神经受压的迹象。强调了计算机断层扫描和眼科检查在治疗方案中的价值。所有患者均接受静脉抗生素治疗,但5例有脓肿形成迹象的患者需要紧急手术引流,3例采用内镜引流,其余2例采用外部手术方法。因此,对于出现急性鼻窦炎眼眶并发症的儿童,及时诊断和治疗对于取得最佳治疗效果至关重要。