[Treatment of acute ethmoiditis according to a protocol based on clinical stage].
OBJECTIVE
To describe the results of application of a systematic treatment protocol, meant to reduce the risk of serious complications, when treating acute ethmoiditis.


METHODS
Prospective study.


METHODS
Academic hospital of the 'Vrije Universiteit (VU)', Amsterdam, The Netherlands.


METHODS
From January 1988 to March 1994, 25 children with acute ethmoiditis were admitted to the VU hospital. Eight of them had Chandler stage I, 8 stage II, 3 stage III, 3 stage IV and 3 stage V. The treatment protocol was stepwise, based on the Chandler stages and focused on intensive antibiotic treatment in combination with surgical drainage of the ethmoid complex and (or) the orbit.


RESULTS
All children with ethmoiditis stages I-III were cured without rest symptoms. One patient with ethmoiditis stage IV and a pre-existent lymphatic leukaemia died of pulmonary complications of a massive fungal infection, 8 months after treatment. One patient with ethmoiditis stage V finally had permanent psychomotor retardation.


CONCLUSIONS
The used treatment protocol offered the possibility to treat patients with acute ethmoiditis stepwise, depending on stage, with satisfying results. Especially the treatment result in patients with ethmoiditis stage V was good.
Middelweerd
M J
MJ
Afd. Keel-, Neus- en Oorheelkunde, Academisch Ziekenhuis Vrije Universiteit, Amsterdam.
Bolt
R J
RJ
van der BURG
G J
GJ
Kloos
R J
RJ
Koole
F D
FD
D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D003952:Diagnostic Imaging; D004322:Drainage; D015521:Ethmoid Sinusitis / Q000145:classification / Q000175:diagnosis / Q000628:therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011446:Prospective Studies
D000900:Anti-Bacterial Agents