Evidence-Based Management of Orbital Complications of Rhinosinusitis in Children
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Purpose of Review
The purpose of this review is to assess recent evidence regarding orbital complications of rhinosinusitis in children and discuss the implications of these findings on current management protocols and clinical practice.
The evidence base for this topic is level 4 and 5, based on case series and expert opinion. There are some cohort studies investigating the public health aspects and microbiology of the disease which guides empirical antibiotic prescribing.
The management of periorbital complications of rhinosinusitis in children is based on low levels of evidence. Expert consensus recommends expeditious cross-sectional imaging with appropriate intravenous antibiotic usage penetrating the blood brain barrier and selective surgical drainage which can be sight saving. There is some evidence to support conservative management of small subperiosteal abscesses. Surgical drainage via endoscopic, open or hybrid technique depends on individual patient circumstances and skill set of the available surgical team. However, the key tenet of all treatment options remains that clinicians should manage expeditiously to avoid visual loss.
KeywordsOrbital cellulitis Periorbital abscess Subperiosteal abscess Orbital disease Paranasal sinus disease Paediatric rhinosinusitis
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Human and Animal Rights and Informed Consent
This article does not contain any studies with human or animal subjects performed by any of the authors.
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