title: Bilateral orbital complications of paediatric rhinosinusitis.
abstract: BACKGROUND
  The spread of infection from the ethmoid sinuses to the orbit occurs directly through a congenital dehiscence of the lamina papyracea or via haematogenous spread through ophthalmic venous system. Hence orbital complications of paediatric rhinosinusitis are usually unilateral at presentation.
  
  
  METHODS
  We describe three children with bilateral orbital cellulitis that occurred as a complication of rhinosinusitis without intracranial spread of the infection. The children ranged in the age group from 4 to 7 years. All these children had a prolonged hospital stay from 14 to 25 days and underwent multiple surgical procedures to drain the subperiosteal abscess. These children presented to the hospital with bilateral orbital cellulitis without significant past history. All of them on radiological evaluation showed subperiosteal abscess involving only one orbit. They were taken up for functional endoscopic sinus surgery and the subperiosteal abscess was drained endoscopically with partial removal of lamina papyracea. One case required second surgery despite good recovery for two days post first surgery.
  
  
  CONCLUSIONS
  Two cases had severe unilateral visual loss at presentation but both recovered dramatically after the surgery. All cases had uneventful recovery with no residual disability. The purpose of this article is to discuss the reasons for bilateral orbital complications of rhinosinusitis at initial presentation despite the previous hypothesis of unilateral involvement.
authors.affiliation: Associate Professor, Dept of ENT, AFMC, Pune-40, India.
authors.forename: S K
authors.initials: SK
authors.lastname: Singh
authors.affiliation: Ex Professor & HOD, Dept of ENT, AFMC, Pune 40, India.
authors.forename: E
authors.initials: E
authors.lastname: James
authors.affiliation: Associate Professor, Dept of ENT, AFMC, Pune-40, India.
authors.forename: K
authors.initials: K
authors.lastname: Sabarigirish
authors.affiliation: Associate Professor, Dept of ENT, AFMC, Pune-40, India.
authors.forename: H
authors.initials: H
authors.lastname: Swami
authors.affiliation: Resident, Dept of ENT, AFMC, Pune 40, India.
authors.forename: Tarun
authors.initials: T
authors.lastname: Sood
keywords: Cavernous sinus thrombosis; Functional endoscopic sinus surgery; Orbital cellulitis; Rhinosinusitis; Subperiosteal abscess