title: Complicated sinusitis in a developing country, a retrospective review.
abstract: OBJECTIVE
  The aim of our study was to assess the incidence rate, mode of presentation, treatment and outcome measures associated with complicated sinusitis in our developing world setting. Additionally we had hope to identify possible patterns or predisposing factors that may assist us in decreasing the significant morbidity and mortality associated with this serious disease.
  
  
  METHODS
  A retrospective chart review was performed on all patients treated for complicated sinusitis at 3 referral hospitals in Durban South Africa between January 2006 and September 2009.
  
  
  RESULTS
  A total of 220 patients were identified including 138 patients with orbital complications only and 82 with intracranial complications with or without orbital manifestations. We report on the demographics, mode of presentation, microbiology, impact on resources, management and mortality of the study group. The incidence rate was found to be 5.83 per million, the most common risk factors associated with intracranial complications, a persistent headache beyond 1 week and referral from a rural rather than urban area (OR 3.24). We found a high mortality rate of 20.7% in those patients with intracranial complications of their sinusitis.
  
  
  CONCLUSIONS
  Complicated sinusitis is still far too common in the developing world with young adolescent males most at risk. A high index of suspicion must be maintained in detecting orbital as well as intracranial extension of disease and appropriate referral for investigation and management swift and aggressive in preventing extensive morbidity and mortality.
authors.affiliation: Department of Otorhinolaryngology Head and Neck Surgery, University of Kwazulu Natal, Umbilo Road Durban, Private Bag X3, Congella 4013, South Africa. kurt.schlemmer@gmail.com
authors.forename: Kurt Denton
authors.initials: KD
authors.lastname: Schlemmer
authors.forename: Shamlan Krishna
authors.initials: SK
authors.lastname: Naidoo
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D003906:Developing Countries; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors; D012852:Sinusitis / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology; D013019:South Africa / Q000453:epidemiology; D055815:Young Adult