Current Otorhinolaryngology Reports

, Volume 6, Issue 1, pp 42–47 | Cite as

Evidence-Based Management of Orbital Complications of Rhinosinusitis in Children

  • Colin G. Leonard
  • Keith G. Trimble
Pediatric Otolaryngology (I Bruce, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pediatric Otolaryngology


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.

Recent Findings

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.


Orbital 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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© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Paediatric OtorhinolaryngologyRoyal Belfast Hospital for Sick ChildrenBelfastIreland

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