Department of Otorhinolaryngology, Ege University Faculty of Medicine, İzmir.
Department of Otorhinolaryngology, Medical Park Tarsus, Mersin, Turkey.
Turk J Pediatr. 2020;62(4):533-540. doi: 10.24953/turkjped.2020.04.002.
Rhinosinusitis is one of the most common infections of childhood. Rhinosinusitis usually limits itself in the pediatric age group, however orbital and intracranial complications may arise in some of the patients. The purpose of the study was to retrospectively analyse the previous treatments and outcomes in pediatric rhinosinusitis patients with orbital complications.
The effect and prognosis of medical treatment and endoscopic sinus surgery are reported in this study. Twenty-five pediatric patients diagnosed with complicated rhinosinusitis between January 2008 - February 2016 were included in the study. Orbital complications, examination findings, radiological imaging and blood counts were retrospectively collected from patient files. The duration of hospitalization, source of the infection, complications, previous medical and surgical treatments were also retrospectively assessed.
Average age of the patients were 8.84 ± 4.02 years (range: 1-16 years). The mean length of stay in hospital was 6.72 ± 3.28 days. Hospitalization in surgically treated group was higher than primarily medically treated group. However this difference could not reach to a statistically significant level (p > 0.05). Mean hospitalization time was found 5.21 ± 2.51 and 8.43 ± 2.87 days in patients diagnosed with preseptal cellulitis and subperiosteal abscess respectively. Hospitalization in patients with subperiosteal abscess was higher than preseptal cellulitis and a statistically significant difference was detected (p < 0.05).
Morbidity and mortality of orbital complications which are the most common complications of pediatric rhinosinusitis, could significantly be reduced by using appropriate treatment methods and an early diagnosis. Conservative therapy is an effective method for patients with preseptal cellulitis and most cases of orbital cellulitis in children.
鼻窦炎是儿童最常见的感染之一。鼻窦炎通常局限于儿科年龄组,但在一些患者中可能会出现眼眶和颅内并发症。本研究的目的是回顾性分析患有眼眶并发症的儿科鼻窦炎患者的既往治疗方法和结果。
本研究报告了药物治疗和鼻内镜鼻窦手术的效果和预后。本研究纳入了 2008 年 1 月至 2016 年 2 月期间诊断为复杂鼻窦炎的 25 例儿科患者。从患者病历中回顾性收集眼眶并发症、检查结果、影像学和血液计数。还回顾性评估了住院时间、感染源、并发症、既往药物和手术治疗情况。
患者的平均年龄为 8.84 ± 4.02 岁(范围:1-16 岁)。平均住院时间为 6.72 ± 3.28 天。手术治疗组的住院时间高于单纯药物治疗组,但差异无统计学意义(p > 0.05)。诊断为眶隔前蜂窝织炎和骨膜下脓肿的患者的平均住院时间分别为 5.21 ± 2.51 和 8.43 ± 2.87 天。骨膜下脓肿患者的住院时间高于眶隔前蜂窝织炎患者,差异有统计学意义(p < 0.05)。
通过使用适当的治疗方法和早期诊断,可以显著降低眼眶并发症(儿科鼻窦炎最常见的并发症)的发病率和死亡率。对于眶隔前蜂窝织炎和大多数儿童眶蜂窝织炎患者,保守治疗是一种有效的方法。