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Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview

2019; Multidisciplinary Digital Publishing Institute; Volume: 8; Issue: 1 Linguagem: Inglês

10.3390/jcm8010101

2077-0383

Sara Torretta, Claudio Guastella, Paola Marchisio, Tal Marom, Samantha Bosis, Tullio Ibba, Lorenzo Drago, Lorenzo Pignataro,

Nasal Surgery and Airway Studies

Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3⁻4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians.