Author(s): Imtiaz Ahmed Khan1, Muneeruddin Ahmed Siddavatum2
Rhinosinusitis remains a common clinical disease encountered in ENT practice. The clinical subtypes include acute, subacute,
recurrent acute and chronic. Acute rhinosinusitis most commonly is of viral aetiology superadded by bacteria. Chronic
Rhinosinusitis (CRS) is commonly a mixed bacterial infection. Even though, the complications are less common when primary
treatment is neglected, the potential of developing intraorbital suppuration, life-threatening intracranial complications will result
in high morbidity and mortality. Incidence of such complications remains high among the populations of poor socioeconomic
status, overcrowding and those living in areas of industrial pollution. The objective of the present study was to evaluate the
incidence, clinical presentations, CT scan findings and different treatment outcomes of orbital complications secondary to
sinusitis in patients from slum areas of industrial belt of Hyderabad.
The aim of the study is to evaluate the incidence, clinical presentations and various treatment modalities and their outcomes
of orbital complications secondary to sinusitis.
MATERIALS AND METHODS
A retrospective study was conducted at Government ENT Hospital, Koti, Hyderabad, reviewing the patients with orbital
complications over a period of 3 years. All the clinical data collected from the case sheets included the clinical presentation,
plain and contrast-enhanced CT scan findings, type of treatment adopted, surgical approaches in their management and the
final outcome of such patients were analysed.
134 patients presented in the Regional ENT Hospital with orbital complications secondary to rhinosinusitis. Medical treatment
was initially successful in 59 (44.02%) patients. Surgical intervention with endoscopic sinus surgery was done in 75 (55.97%)
patients. 12 patients (8.95%) were drained externally, which included Caldwell-Luc operations and orbital exenteration. The
mortality was in 5 (3.73%) of the total patients. Allergic fungal sinusitis was found in 29 (21.64%) and invasive fungal sinusitis
was found in 9 (6.71%).
Orbital complications secondary to rhinosinusitis have good prognosis if detected early and treated appropriately on priority
basis. Awareness among the physicians primarily treating the patients with sinusitis in the community towards this problem and
early referral to a tertiary hospital for proper management is essential to avoid mortality and morbidity.