International journal of pediatric otorhinolaryngology · 2026
Long-term outcomes after recovery from pediatric acute sinusitis with orbital complications.
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Phung Chau, Wei Kimberly, Rizzi Mark D, Buzi Adva
Аннотация
OBJECTIVE: This study aims to assess whether an occurrence of acute sinusitis with orbital complications in childhood is associated with the development of long-term complications, including the development of chronic rhinosinusitis (CRS), and to identify clinical factors associated with persistent or recurrent disease.
STUDY DESIGN: Retrospective cohort study.
SETTING: A tertiary children's hospital.
METHODS: We reviewed records of children diagnosed with acute sinusitis with orbital complications at a tertiary institution from January 2017 to June 2023. Episodes of subsequent acute sinusitis, sinus surgery, or the development of CRS were quantified and evaluated for correlation with several risk factors.
RESULTS: One hundred eighty-one patients were included in the study. Average follow-up was 647 days. The mean age was 8.2 years and 66.3% were male. Medical management for the initial infection was more common (66.9%), while 33.1% underwent surgery. Mean hospital stay was 3.9 days, with 7.8% 30-day readmissions. Seven patients (3.9%) experienced another episode of complicated sinusitis similar to their initial presentation, and three (1.7%) required subsequent sinus surgery after resolution of the initial infection. CRS was subsequently diagnosed in 14 (7.8%) patients. There was no significant association between risk factors and our primary outcomes. Among 23 patients with follow-up imaging, mean Lund-Mackay scores improved (7.6 to 1.7).
CONCLUSIONS: Most children with orbital complications of sinusitis recovered without long-term sequelae, and a small proportion developed CRS. Disease severity at presentation or initial treatment did not predict long-term outcomes. These findings suggest that routine follow up with primary care providers after the initial presentation was appropriate for most children.
STUDY DESIGN: Retrospective cohort study.
SETTING: A tertiary children's hospital.
METHODS: We reviewed records of children diagnosed with acute sinusitis with orbital complications at a tertiary institution from January 2017 to June 2023. Episodes of subsequent acute sinusitis, sinus surgery, or the development of CRS were quantified and evaluated for correlation with several risk factors.
RESULTS: One hundred eighty-one patients were included in the study. Average follow-up was 647 days. The mean age was 8.2 years and 66.3% were male. Medical management for the initial infection was more common (66.9%), while 33.1% underwent surgery. Mean hospital stay was 3.9 days, with 7.8% 30-day readmissions. Seven patients (3.9%) experienced another episode of complicated sinusitis similar to their initial presentation, and three (1.7%) required subsequent sinus surgery after resolution of the initial infection. CRS was subsequently diagnosed in 14 (7.8%) patients. There was no significant association between risk factors and our primary outcomes. Among 23 patients with follow-up imaging, mean Lund-Mackay scores improved (7.6 to 1.7).
CONCLUSIONS: Most children with orbital complications of sinusitis recovered without long-term sequelae, and a small proportion developed CRS. Disease severity at presentation or initial treatment did not predict long-term outcomes. These findings suggest that routine follow up with primary care providers after the initial presentation was appropriate for most children.