Saturday, 04 March 2023 06:05

Medical treatment for orbital complications secondary to rhinosinusitis Featured

Rate this item
(1 Vote)

Original Research:

Ali O. Muthanna


Background: Despite the modern antibiotherapies applied in the practice of otorhinology, the orbital complications of sinusitis are still considered a serious threat to essential  functions of the eye, including loss of vision and life threatening .

Aim: This study aimed to evaluate efficiency of medical treatment in orbital complications secondary to rhinosinusitis.

Methods: It was a hospital based Prospective study. Patients diagnosed with orbital complications secondary to rhinosinusitis were enrolled in this study. During the period January 2014 June 2021, at OtoRhinoLaryngoloy, Head & Neck Department, at Al-Thawra Teaching Hospital, Sana'a, Yemen.  All patients underwent to clinical examination, radiological investigations (CT, MRI), initially aggressive medical treatment by IV. antibiotic and locally nasal decongestant for 24-48 hours, if there is no evidence of improvement, we intervened with a surgical procedure, by nasal endoscopy  or external approach in the form of external ethmoidectomy to evacuate collection of pus.

Results: A total of 30 patients complained of orbital complications secondary to rhinosinusitis  were included in the study. Age ranged between two and 50 year, 73.3% of the patients was males and 26.7% was females. Children were the most category affected 24 patients, right was more than left side ethmoid sinus was the most sinus affected, followed by ethmoid and maxillary sinuses together. Preseptal cellulitis was the commonest complication among the patients (53.3%), orbital cellulitis and subperiosteal abscess occurred in 20% of the patients. Medical treatment succeeded in 80% of the patients, surgical procedure under covering of antibiotic was done in 20% of the patients.

Conclusion: Orbital complications were the most common complications secondary to rhinosinusitis and were more in the children. The outcome of the treatment depended on  the types of complications. Medical treatment was showed high efficiency rate.


Keywords: Orbital complications, Rhinosinusitis, Surgical procedure, Medical treatment


Ali O. Muthanna

Department of Otolaryngology, Head and Neck Surgery, Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen


For Correspondence:

Ali O. Muthanna
Faculty of Medicine and Health Sciences, Sana’a University, Sana’a, Yemen
Tel: +967 777431487
Email: This email address is being protected from spambots. You need JavaScript enabled to view it.
P.O. Box No: 20418, Sana'a, Yemen    


  1. Hermann BW, Forsen JW. Simultaneous intracranial and orbital complications of acute rhinosinusitis. Int J Pediatr OtoLaryngol. 2004;68:619-625.
  2. Chandler JR, Langebrunner DR, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 1970;80;1414-1428.
  3. Wong SL, Levi J. Management of pediatric orbital complications: a systemic review . Int. J Pediatric Otorhinolaryngol. 2018;110:123-129. Doi;10.1016/ijporl.2018,05.006
  4. Courdert A, Khalfallah S, Suy P, Truy E. Microbilogy and antibiotic therapy of subperiosteal orbital abscess in children with acute ethmoiditis .Int J Pediatric Otorhinolaryngol. 2018;106:91-95.
  5. Babar T F, Zama M, Kan MN, Kan MD. Risk factors of pre-septal and orbital cellulitit.J Call physicians Surg Pak 2009;19:39-42
  6. Radovani P, Vasili D, Xhelili M, Dervishi J. Orbital complications of sinusitis. Balkan Med J. 2013;30:151-154.
  7. Ali A, Kurien M, Matheus SS, Mathew J. Complications of acute infective rhinosinusitis experience from a developing country.Singapore Med J. 2005;46:540-544.
  8. Suhaili DN, Goh BS, Gedeh BS. A ten years retrospective review of orbital Complications secondary to acute sinusitis in children. Med J Malaysia. 2010;65(1):49-52.
  9. SiedeK V, Kemer A, Betz CS, Tschiesner U, Berghaus A, Leunig A. Management of orbital complications due to rhinosinusitis. Eur Arch Otorhinolaryngol. 2010;267:1881-1886.
  10. Chang YS, Chen PL, Hung JH,Chen HY, Lai CC, Ou Y, et al. Orbital complications of paranasal sinusitis in Taiwan,1988 through 2015: acute ophthalmological  manifestations, diagnosis and management. Plose One. 2017;12(10):e184477.
  11. AL-Madani MV, Khatatbeh AF, Rawashdeh RS, AL-Khoum NF, Shawagefeh NR. The prevalence of orbital complications among children and adults with acute  Braz J Otorhinolaryngol 2013.79:http//dx doi org/10-5935/1808-8694.2013131
  12. Pena MT, Preciado D, Orestes M, Choi S. Orbital complications of acute sinusitis change in the post-pneumococcal vaccine Era. JAMA Otolaryngol Head Neck Surg. 2013;139(3):223-227
  13. Mortimore S, Wormald PJ. The Goote Schuur hospital classification of the orbital complications of sinusitis. J Larynol Otol. 1997;111:719-723.
  14. Peter A, Mohammed DI. Results of orbital cellulitis treatment. J Natural Scien Rerearch 2012;2(5): 91-95
  15. Jones NS, Walker JL, Bassi S, Jones T, Punt J. The intracranial complications of rhinosinusitis: can they be prevented? Laryngoscope 2002;112:59-63.
  16. Bolinaga U, Petez N, Labato R, Martinez-Seijas P, Sumtier Perez E. Abscess of the orbit as a complication of acute sinusitis: surgical approach. Eur Arch of otorhinolaryngol. 2009;266:(A368):1037-1038.
  17. Rubin F, Pierrot S , lebreton M, Contencin P, Couloigner V. Drainage of subpereosteal orbital abscess complicating pediatric ethmoiditis: comparison between external and trasnasal approaches. Int J Pediatric Otorhinolaryngol. 2013;77(5): 796-802
  18. Wong SJ, Levi J. Management of pediatric orbital cellulitis: a systemic review. Int J pediatr Otorhinolaryngol. 2018;110:123-129.
  19. Oxford LE, McClay J. Medical and surgical management of subperiosteal orbital abscess secondary to acute sinusitis in children. Int J Pediatr Otorhinolaryngol. 2006;70(11):1853-1861.
  20. Ismi O, VayisogluY, Dinc E, Yildirim O, Unal M. Central retinal artery occlusion and irreversible blindness due to  paranasal sinus infection in a pregnant women. J Craniofac  2014;25:557-579.  
  21. Dhangra BA, Linder L, Preciado DA, Taylormoore J, Shah RK. Orbital pireorbital infections Anational prespective.Arch Otolarygol Head Neck Surg. 2011;137(8):769-773.
  22. Chavan SS, Deshmukh DS, Pawar VG, Kirpan VG, Khobragade SW, Sarvade k, et al. OrbitalComplications of sinogenic origin: A case study of 20 patients. Word articles in ear, nose, and throat 2010 ;3. www.waent/ archives/ 2010/vol 3-2/10.html.
  23. Rashed F, Canon A, Heaton PA, Pual SP. Diagnosis, management and treatment orbital and periorbital cellulitis in children. Emerg Nurse. 2016;24(1):30-35.
  24. Singh CSK, James SCE, Sabarigirish CK, Sawami WH, Sood MT. BilateraL orbital complications of pediatric rhinosinositis. MJAFI. 2014;70:68-72.
  25. Chaiyate S, Fooanant S, Navacharoen N, Roongrotwattanasiri K, Pongsakom T, Patumanond J. Complications of sinusitis in a tertiary Care Hospital: types, patients Characteristics and outcomes. Int J Otolaryngol. 2015 feb 2 doi.10 -1155/2015/709302.
  26. Wan Y, Shi G, Wang H. Treatment of orbital complication following acute rhinosinusitis in children. Balkan Med J. 2016;33(4):401-406.
  27. Adeoti CO, Adejumo OO, Isawumi MA, Kolawole OO, Haastrup AA. Orbital cellulitis in a tertiary institution. Niger J Ophthalmol. 2017;25:141-145.
  28. Ben Mabrouk K, Wannes S, Hasnaoui M, Werdani A, Ben Hamida N, Jebri S, etal. U Orbital complication of acute ethmoiditis: Tunisian pediatric cross section study. Am J Otolaryngol. 2020;41: 103.320.
  29. Mohamad ZS , Cyrus CR, Kunal S P, Todd J W, Rao VC, Elisa A L, Jonathan YT. Orbital complications of acute sinusitis in pediatric patients: management of  Chandler 111 patients. Allergyand rhinology. 2022;13:1-9.
Read 868 times Last modified on Saturday, 04 March 2023 07:17

About AMH

Annals of Medicine & Health (AMH) is a peer reviewed medical journal that established and published by a governmental medical faculty titled Thamar University Faculty of Medicine & Health Sciences (TUFMHS). 


Faculty of Medicine & Health Sciences AL-Mohafadhah St. Dhamar City - Yemen

P.O.Box: 87246

Tel Fax: +967 6 509 578

Tel No: +967 6 509 577


Copyright © 2019 Thamar University - Faculty of Medicine and Health Sciences - Annals of Medicine & Health . All Rights Reserved. | Developed By ProSite Yemen