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Daniel A, Novoa R, Pansky I, Hazan I, Friedrich L, Kordeluk S, Tsumi E, Cohen O, Ziv O. The association between sinonasal anatomical variants and the laterality of orbital complications in pediatric acute rhinosinusitis. Int J Pediatr Otorhinolaryngol 2024; 180:111958. [PMID: 38657427 DOI: 10.1016/j.ijporl.2024.111958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/28/2024] [Accepted: 04/13/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION As the role of sinonasal anatomical variants as predisposing factors in determining the lateralization of acute rhinosinusitis-related orbital complications (ARS-OC) in pediatrics remains a topic of debate, this study further explores the potential association between anatomical variations and ARS-OC. METHODS A retrospective study was conducted on children who had been admitted with ARS-OC using medical records and sinus CT scans to compare anatomical differences between the affected and contralateral sides. This study aimed to identify bony anatomical disparities that may impact OC laterality secondary to ARS. The anatomical features examined included septal deviation, concha bullosa, lamina papyracea dehiscence (LPD), and uncinate process abnormalities. RESULTS The CT scans of 57 pediatric patients (114 sides) were reviewed. Our results indicated that bony anatomical variations were associated with ARS-OC laterality (63 % vs. 37 %, P = 0.006), yielding an odds ratio of 2.91. Additionally, our study revealed a significant association between ipsilateral LPD with the increased risk of ARS-OC (39 % vs. 1.8 %, P < 0.05), with an odds ratio of 34.3 compared to the opposite side. CONCLUSIONS LPD might play a role in the pathophysiology of pediatric ARS-OC, as it is associated with a significantly higher risk of affecting the ipsilateral side. Further research is necessary to determine whether LPD is a causative factor or a result of ARS.
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Affiliation(s)
- Aviv Daniel
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Otorhinolaryngology Department, Soroka University Medical Center, Beer Sheva, Israel.
| | - Rosa Novoa
- Radiology Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Itay Pansky
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Itai Hazan
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Clinical Research Center, Soroka University Medical Center, Beer Sheva, Israel
| | - Lior Friedrich
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel
| | - Sofia Kordeluk
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Otorhinolaryngology Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Erez Tsumi
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Ophthalmology Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Oded Cohen
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Otorhinolaryngology Department, Soroka University Medical Center, Beer Sheva, Israel
| | - Oren Ziv
- Faculty of Health Science, Ben-Gurion University of the Negev, Beer Sheva, Israel; Otorhinolaryngology Department, Soroka University Medical Center, Beer Sheva, Israel
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Martinez-Fernandez E, Sanchez-Tocino H, Calles Monar PS, Galindo-Ferreiro A. Recurrent bilateral asynchronous cellulitis: Report of two cases and a literature review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2022; 97:113-116. [PMID: 35152947 DOI: 10.1016/j.oftale.2020.10.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 10/14/2020] [Indexed: 06/14/2023]
Abstract
Bilateral recurrent periorbital cellulitis is a very rare condition, with only five cases having been reported. Two cases are presented of recurrent bilateral asynchronous eyelid oedema in two paediatric patients. It was associated with respiratory infections, with no systemic disease. The patients had recurrent episodes (three times) since nine months old. They received oral and intravenous antibiotics, with a good response. There were no complications and no surgery was needed.
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Affiliation(s)
- E Martinez-Fernandez
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain.
| | - H Sanchez-Tocino
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
| | - P S Calles Monar
- Departamento de Oftalmología, Complejo Asistencial Universitario de Palencia, Palencia, Spain
| | - A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, Spain
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Yulia DE, Mahyuddin M, Alatas SSS, Soeharto DA. Resolution of refractory orbital cellulitis in an immunocompetent child: A case report. Int J Surg Case Rep 2022; 90:106737. [PMID: 34973629 PMCID: PMC8728424 DOI: 10.1016/j.ijscr.2021.106737] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction Orbital cellulitis in children is a potentially fatal emergency and develops rapidly, leading to severe visual loss and life-threatening complications. Presentation of case We report a case of a 16-month-old girl who presented to the emergency department unconscious with a four-day history of a swollen right eyelid. CT scan revealed soft tissue swelling at the superior and inferior palpebral region with bilateral maxillary sinusitis. She had a severe sepsis and received intravenous antibiotics. After her general condition improved, she underwent surgical drainage in conjunction with mini-FESS (functional endoscopic sinus surgery)-the culture of purulent material from which Staphylococcus Aureus was isolated. After a few days, she had hospital-acquired pneumonia, and an abscess in her right eyelid reformed. Immunoglobulin test and lymphocyte subset test was normal. The patient underwent re-surgical drainage and had complete resolution of refractory orbital cellulitis. Discussion Severe refractory orbital cellulitis secondary to indolent infection is oftentimes found in immunocompromised patients or in those with underlying ocular diseases; our immunocompetent patient had a seemingly mild case of sinusitis which quickly progressed to severe orbital cellulitis. Oftentimes, broad-spectrum antibiotics are sufficient to treat orbital cellulitis, however, the same cannot be said for our patient, abscess reformed despite appropriate definitive antibiotic therapy in accordance with the culture results. Conclusion While the main treatment of orbital cellulitis is administration of antibiotics, in certain conditions as found in our patient, patients may not respond well to conservative treatment. Thus, close monitoring is essential, and any sign of progression warrants prompt surgical drainage. Severe orbital cellulitis from mild sinusitis can occur despite immunocompetence. Unresponsiveness to definitive culture-based antibiotic treatment before surgery Prompt surgical drainage must be considered if patient shows signs of progression. Nosocomial infection and sepsis may complicate orbital cellulitis.
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Affiliation(s)
- Dian E Yulia
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo National Hospital, Jakarta, Indonesia.
| | - Mutmainah Mahyuddin
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Sahar S S Alatas
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
| | - Diajeng A Soeharto
- Department of Ophthalmology, Faculty of Medicine, Universitas Indonesia/Cipto Mangunkusumo National Hospital, Jakarta, Indonesia
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Martinez-Fernandez E, Sanchez-Tocino H, Calles Monar PS, Galindo-Ferreiro A. Recurrent bilateral asynchronous cellulitis: Report of two cases and a literature review. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2020; 97:S0365-6691(20)30431-7. [PMID: 33358470 DOI: 10.1016/j.oftal.2020.10.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/05/2020] [Accepted: 10/14/2020] [Indexed: 11/22/2022]
Abstract
Bilateral recurrent periorbital cellulitis is a very rare condition, with only five cases having been reported. Two cases are presented of recurrent bilateral asynchronous eyelid oedema in two paediatric patients. It was associated with respiratory infections, with no systemic disease. The patients had recurrent episodes (three times) since nine months old. They received oral and intravenous antibiotics, with a good response. There were no complications and no surgery was needed.
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Affiliation(s)
- E Martinez-Fernandez
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España.
| | - H Sanchez-Tocino
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
| | - P S Calles Monar
- Departamento de Oftalmología, Complejo Asistencial Universitario de Palencia, Palencia, España
| | - A Galindo-Ferreiro
- Departamento de Oftalmología, Hospital Universitario Río Hortega, Valladolid, España
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Al Akrash LS, Al Semari MA, Al Harithy R. Ocular manifestations of dermatological diseases part I: infectious and inflammatory disorders. Int J Dermatol 2020; 60:5-11. [PMID: 33232519 DOI: 10.1111/ijd.15101] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 06/11/2020] [Accepted: 07/13/2020] [Indexed: 12/21/2022]
Abstract
Skin and eyes share a common embryological origin from the embryonic surface ectoderm. Ocular manifestations are one of the most important and common associations of dermatological diseases. Currently, there are few comprehensive reviews of the ocular manifestations of dermatological diseases. We have reviewed more than 40 published articles related to the ocular manifestations of the most important dermatological diseases. The search included Pubmed, Google Scholar, and Cochrane databases from 2014 to 2019. This review was divided into three parts including infections, inflammatory, genetics, connective tissue, autoimmune, neoplasms, and drug-related disorders. We excluded metabolic, endocrine, and nutrition-related dermatological diseases. The relationship of ocular manifestations and dermatological diseases is important to recognize for appropriate management since many dermatological diseases can manifest initially with ocular findings. In this part, we summarized the most common and significant ocular findings in infectious and inflammatory dermatological disorders with appropriate referral recommendations to ophthalmology.
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Affiliation(s)
- Lamia S Al Akrash
- Dermatology Department, King Fahad Medical City, Riyadh, Saudi Arabia
| | | | - Ruaa Al Harithy
- Dermatology Department, Security Forces Hospital, Riyadh, Saudi Arabia
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Orman G, Kralik SF, Desai N, Meoded A, Vallejo JG, Huisman TAGM, Tran BH. Imaging of Paranasal Sinus Infections in Children: A Review. J Neuroimaging 2020; 30:572-586. [PMID: 32472739 DOI: 10.1111/jon.12737] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2020] [Accepted: 05/13/2020] [Indexed: 12/17/2022] Open
Abstract
Paranasal sinuses (PNS) infections are common in children. They may cause common and well-known complications, but also, unusual and potentially devastating complications. Diagnosing PNS infections and complications in children requires knowledge of the unique anatomy of the nasal cavity and the PNS. In fetal life, nasal mucosa evaginations into the lateral nasal walls initiate the development of the PNS. The PNS continue to develop after birth and complete their maturation and pneumatization at different ages during childhood which makes the pattern of PNS infections determined by patient age. Complications are caused by direct spread of the infection to the orbit, face, intracranial or osseous structures or hematogenous spread of the infection to the intracranial structures. Emergent imaging studies are often necessary in the evaluation of the complications in pediatric patients when the symptoms persist for 10 days and/or if there is evidence of intracranial or orbital complications. In addition, immunocompromised children are especially vulnerable to developing unusual complications. Computed tomography (CT) is excellent for determining whether there is intraorbital extension of PNS disease. However, when the infection approaches the orbital apex, a magnetic resonance imaging (MRI) study with contrast is necessary to assess spread into the cavernous sinus and the intracranial compartment. The goal of this manuscript is to review and characterize imaging findings of PNS infections using CT and MRI allowing determination of the extent of PNS infections and their common and unusual complications in children. In addition, a summary of the development of the normal PNS is provided.
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Affiliation(s)
- Gunes Orman
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Stephen F Kralik
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Nilesh Desai
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Avner Meoded
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
| | - Jesus G Vallejo
- Department of Pediatrics, Section of Infectious Diseases, Texas Children's Hospital and Baylor College of Medicine, Houston, TX
| | | | - Brandon H Tran
- Edward B. Singleton Department of Radiology, Texas Children's Hospital, Houston, TX
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Leonard CG, Trimble KG. Evidence-Based Management of Orbital Complications of Rhinosinusitis in Children. CURRENT OTORHINOLARYNGOLOGY REPORTS 2018. [DOI: 10.1007/s40136-018-0187-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Getting the message across. An August bank holiday long ago. The Journal of Laryngology & Otology 2017; 131:657. [DOI: 10.1017/s0022215117001529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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