Imaging characteristics and clinical correlations of orbital infections in pediatric sinusitis.

BACKGROUND: To analyze the imaging characteristics of orbital infections associated with pediatric sinusitis. METHODS: A retrospective analysis was conducted on medical records of children diagnosed with sinusitis-related orbital infections over a 13-year period at Shanxi Provincial Children’s Hospital. RESULTS: A total of 150 cases were collected and diagnosed according to Chandler’s criteria: Stage I (74 cases), Stage II (42 cases), Stage III (24 cases), Stage IV (6 cases), and Stage V (4 cases). Ethmoid sinusitis was present in 91.3% (95% CI 85.7%–94.9%) of cases and maxillary sinusitis in 96.7% (95% CI 92.4%–98.6%). Ethmoid and frontal sinusitis were significantly correlated with post-septal orbital infections (χ2_ethmoid = 4.335, P_ethmoid = 0.037, odds ratio 3.80 [95% CI 1.00–14.42]; χ2_frontal = 3.882, P_frontal = 0.049, odds ratio 2.55 [95% CI 0.98–6.63]). Ethmoid sinusitis was also associated with subperiosteal abscess formation on the medial orbital wall (χ2 = 15.273, P = 0.011, odds ratio 0.12 [95% CI 0.04–0.40]). Five cases showed discontinuity of the lamina papyracea, with a significant correlation between its defect and the formation of subperiosteal abscesses (χ2 = 7.340, Fisher’s exact test P = 0.007, odds ratio 8.86 [95% CI 1.40–56.22]). CONCLUSIONS: Pediatric maxillary and ethmoid sinusitis are likely to cause orbital infections. Ethmoid and frontal sinusitis are more prone to cause post-septal infections. Ethmoid sinusitis, along with defects in the lamina papyracea, is closely related to the formation of subperiosteal abscesses on the medial orbital wall.