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Orbital complications of acute rhinosinusitis: a new classification

By Antonio Augusto Velasco e Cruz, Ricardo Cassiano Demarco, Fabiana Cardoso Pereira Valera, Antônio Carlos dos Santos, Wilma Therezinha Anselmo-Lima and Regina Maria da Silva Marquezini


SummaryRhinosinusitis is a severe sickness and may have serious complications. Orbital complications happen more often, due to anatomical particularities and are lethal in 5% of patients. They vary from inflammatory signs to proptosis, loss of ocular motility and blindness. Aim: We propose a new classification of acute rhinosinusitis complications. Methods: A review of 83 patients with CT scan and clinical reports. Patients were evaluated at HCFMRP-USP between 1995 and 2005 and were diagnosed with complicated rhinosinusitis. Results: In sixty-six patients, were identified three types of orbital complications: orbital cellulitis (46. 9%), subperiosteal abscess (40. 9%) and orbital abscess (12.1%). Seventeen were considered as eyelid infections and excluded from this new classification system. Conclusions: The existing classifications of orbital complications, as Chandler’s, do not consider the orbit’s anatomical characteristics and became obsolete after the development of the CT scan. This study proposes a new, more objective classification to guide the physician in establishing lines of conduct for each case

Publisher: Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial. Published by Elsevier Editora Ltda.
Year: 2007
DOI identifier: 10.1016/S1808-8694(15)30130-0
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