Abstract
Background: The extent of surgery required in the management of pediatric non-medial subperiosteal orbital abscess (SPOA) due to medically refractory complicated acute sinusitis is unknown. Objectives: The primary objective is to compare operative outcomes of children treated with combined endoscopic sinus surgery (ESS) and external orbital drainage (EOD) versus those treated with EOD alone. Methods: Retrospective case series from a tertiary children’s hospital analyzing outcomes in children requiring surgical management for acute sinusitis complicated by non-medial SPOA between November 2007 and September 2019. Results: Sixteen children with a mean age of 9.4 years (95% CI: 7.3–11.4) met inclusion. Eleven (68.8%) underwent combined EOD and ESS, while five (31.2%) underwent EOD alone. Groups were similar in age, symptom duration, white blood cell count, C-reactive protein level, intraocular pressure, Lund-Mackay score, and abscess volume. There was no significant difference in median length of stay between patients treated with a combined approach versus those treated by EOD alone. Cultures identified non-beta-hemolytic Streptococcus species in 56.3% of patients, with Streptococcus intermedius representing the most common organism in 37.5%. In one case, ESS identified a pathogen not acquired via concomitant EOD, which did influence management. No child required a subsequent surgical procedure and there were no operative complications. Conclusions: The addition of ESS in the management of pediatric non-medial SPOA was not associated with a statistically different duration of hospitalization. Cultures from concomitant ESS rarely aided in diagnosis or antibiotic therapy. Further study should delineate the indications for ESS in these cases.
Original language | English (US) |
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Pages (from-to) | 288-295 |
Number of pages | 8 |
Journal | American Journal of Rhinology and Allergy |
Volume | 35 |
Issue number | 3 |
DOIs | |
State | Published - May 2021 |
Externally published | Yes |
Keywords
- acute pediatric sinusitis
- endoscopic sinus surgery
- external drainage
- hospitalization length
- orbital complications
- orbitotomy
- pediatric sinus surgery
- pediatric sinusitis
- sinus cultures
- subperiosteal orbital abscess
ASJC Scopus subject areas
- Immunology and Allergy
- Otorhinolaryngology