Laryngo- rhino- otologie · 2015
[Management of Orbital Complications].
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Knipping S, Hirt J, Hirt R
Аннотация
OBJECTIVE: Orbital complications of sinusitis represent serious diseases. In clinical practice, the term "orbital phlegmon" is often used, although this most serious expression of orbital infection is very rarely seen. However, a correct classification in each stage of orbital complications and resulting treatment recommendations are crucial for the prognosis of the patient.
MATERIAL AND METHODS: Data from 49 patients who underwent treatment for orbital complications from 01/01/2000 until 31/12/2010 were retrospectively analysed. In particular, data on the epidemiology, diagnostic procedures and treatment methods were analyzed.
RESULTS: From the observation period 109 patient records with the diagnosis "orbital affections" (ICD-10 H05) could be identified. Overall, data from 49 patients (36 male and 13 female) with orbital complications of sinusitis could be analyzed. 53.1% of the patient population were children and adolescents aged 1-20 years. Orbital complications were classified using the classification according to Chandler. The group I and II according to Chandler emerged most frequently. 26 patients (53.1%) showed a preseptal cellulitis (group I) and 11 patients (22.4%) had an orbital cellulitis (group II). Patients from group III or higher according to Chandler received a combined medical and surgical treatment.
CONCLUSIONS: Orbital complications of sinusitis mostly seem to arise in infancy and adolescence. With prompt identification of the orbital complications in stage I and II of Chandler, conservative therapy only could be successful. From the third stage up, sinus surgery needs to be considered. The classification of Chandler allows a correct recommendation of therapy.
MATERIAL AND METHODS: Data from 49 patients who underwent treatment for orbital complications from 01/01/2000 until 31/12/2010 were retrospectively analysed. In particular, data on the epidemiology, diagnostic procedures and treatment methods were analyzed.
RESULTS: From the observation period 109 patient records with the diagnosis "orbital affections" (ICD-10 H05) could be identified. Overall, data from 49 patients (36 male and 13 female) with orbital complications of sinusitis could be analyzed. 53.1% of the patient population were children and adolescents aged 1-20 years. Orbital complications were classified using the classification according to Chandler. The group I and II according to Chandler emerged most frequently. 26 patients (53.1%) showed a preseptal cellulitis (group I) and 11 patients (22.4%) had an orbital cellulitis (group II). Patients from group III or higher according to Chandler received a combined medical and surgical treatment.
CONCLUSIONS: Orbital complications of sinusitis mostly seem to arise in infancy and adolescence. With prompt identification of the orbital complications in stage I and II of Chandler, conservative therapy only could be successful. From the third stage up, sinus surgery needs to be considered. The classification of Chandler allows a correct recommendation of therapy.