Modern Pediatrics. Ukraine. (2023). 4(132): 80-84. doi 10.15574/SP.2023.132.80
Havrylenko Yu. V.¹, Syniachenko V. V.¹, Biletska M. A.¹, Ruban I. I.^2
1Shupyk National University of Healthcare of Ukraine, Kyiv
²City Children’s Clinical Hospital No. 1 of Kyiv, Ukraine

For citation: Havrylenko YuV, Syniachenko VV, Biletska MA, Ruban II. (2023). Rhinogenic orbital complications of acute rhinosinusitis in children. Modern Pediatrics. Ukraine. 4(132): 80-84. doi 10.15574/SP.2023.132.80.
Article received: Feb 05, 2023. Accepted for publication: May 16, 2023.

Purpose – to determine the frequency and prevalence of rhinogenic orbital complications (RОC) in children with acute rhinosinusitis (ARS) depending on their gender and age, with an analysis of the treatment performed in the pediatric ENT department.
Materials and methods. A retrospective analysis of 61 patients with ROС at АRS in children who were treated in the otorhinolaryngology department of the City Children’s Hospital No. 1 in Kyiv from 2016 to 2020 was conducted. The diagnosis was established on the basis of the anamnesis, general clinical examination, endoscopic examination and radiological methods of diagnosis (X-rays or CT of paranasal sinuses).
All patients received complex treatment with a parenteral antibiotic and were examined by related specialists: an ophthalmologist, a pediatrician, a neurologist or a neurosurgeon as needed.
Results. The average age of the patients was 5 years and 2 months. There were 34 (55.7%) boys, 27 (44.3%) girls. In 38 (62.3%) sick children, reactive swelling of the eyelids of the right eye was diagnosed, in 22 (36.1%) reactive swelling of the eyelids of the left eye, in one (1.6%) case, periostitis of the right orbit was diagnosed.
All patients with ROС on the background of АRS received parenteral antibacterial therapy with one or two drugs, among which ceftriaxone was prescribed in 98.3%, metrogyl in 41%, macrolide in 21.3%, and amoxicillin in 1.6% of cases.
3 (5%) patients underwent surgical treatment – puncture and drainage of the maxillary sinus, 2 (3.7%) sick children underwent frontotomy with sinus drainage. Complex conservative treatment without surgical intervention was effective in 56 (91.3%) patients. The average length of hospital stay was 7.7 days.
Conclusions. In children with АRS, ROС occurs most often at the age of 3 to 7 years (49.2%) and manifests itself in the form of reactive swelling of the eyelids of the right eye in 62.3% and in 36.3% of the left eye.
Timely antibiotic therapy in patients with АRS of children with ROС makes it possible to effectively treat this pathology without the use of surgical methods.
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the authors.
Keywords: rhinogenic orbital complications, children, rhinosinusitis, antibacterial therapy.

REFERENCES

1. Conti-Ramsden G, Botting N. (2008). Emotional health in adolescents with and without a history of specific language impairment (SLI). Journal of Child Psychology and Psychiatry. 49 (5): 516-525. https://doi.org/10.1111/j.1469-7610.2007.01858.x; PMid:18221347

2. DeMuri GP, Wald ER. (2011, Aug). Complications of Acute Bacterial Sinusitis in Children. The Pediatric Infectious Disease Journal. 30 (8): 701-702. https://doi.org/10.1097/INF.0b013e31822855a0; PMid:21750448

3. Eviatar E, Gavriel H, Pitaro K, Vaiman M, Goldman M, Kessler A. (2008, Dec). Conservative treatment in rhinosinusitis orbital complications in children aged 2 years and younger. Rhinology. 46 (4): 334-337. PMID: 19146006.

4. Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S et al. (2020, Feb 20). European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology. 58 (S29): 20-21, 56. https://doi.org/10.4193/Rhin20.600; PMid:32077450

5. Laiko AA, Zabolotna DD, Borysenko OM ta in. (2021). Dytiacha otorynolarynholohiia. Kyiv: Lohos: 585.

6. Sinclair CF, Berkowitz RG. (2007). Prior antibiotic therapy for acute sinusitis in children and the development of subperiosteal orbital abscess. Int. J. Pediatr. Otorhinolaryngol. 71 (7): 1003-1006. https://doi.org/10.1016/j.ijporl.2007.02.013; PMid:17481738

7. Sobol SE, Marchand J, Tewfik TL, Manoukian JJ, Schloss MD. (2002, Jun). Orbital complications of sinusitis in children. J Otolaryngol. 31 (3): 131-136. https://doi.org/10.2310/7070.2002.10979; PMid:12121013

8. Suhaili DNP, Goh BS, Gendeh BS. (2010). A ten year retrospective review of orbital complications secondary to acute sinusitis in children. Med J Malaysia. 65 (1): 49-52.

9. Wald ER, Applegate KE, Bordley C, Darrow DH, Glode MP, Marcy SM et al. (2013, Jul). Clinical practice guideline for the diagnosis and management of acute bacterial sinusitis in children aged 1 to 18 years. Pediatrics. 132 (1): e262-280. https://doi.org/10.1542/peds.2013-1071; PMid:23796742