Orbital complications of acute rhinosinusitis: a new classification.
Rhinosinusitis 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.


OBJECTIVE
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 Chandlers, do not consider the orbits 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.
Velasco e Cruz
Antonio Augusto
AA
Universidade de São Paulo - Ribeirão Preto Medical School.
Demarco
Ricardo Cassiano
RC
Valera
Fabiana Cardoso Pereira
FC
dos Santos
Antônio Carlos
AC
Anselmo-Lima
Wilma Therezinha
WT
Marquezini
Regina Maria da Silva
RM
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology*; D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002481:Cellulitis / Q000000981:diagnostic imaging / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000145:classification / Q000000981:diagnostic imaging / Q000209:etiology*; D012189:Retrospective Studies; D012220:Rhinitis / Q000150:complications* / Q000000981:diagnostic imaging; D012852:Sinusitis / Q000150:complications* / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed