title: [Management of ocular and orbital complications in acute sinusitis].
abstract: OBJECTIVE
  Describe the clinical presentations of orbital complications of acute sinusitis and discuss therapeutic approaches.
  
  
  METHODS
  Retrospective study of 29 cases of acute sinusitis with orbital extension hospitalized over a period of 12years (2000 to 2012).
  
  
  RESULTS
  There were 23 men and 6 women. The mean age was 15.75years. The average time until consultation was 7.68 days. Sinusitis was ethmoido-maxillary in 20 cases, ethmoidal in 6 cases, and frontal in 3 cases. Orbital extension was grouped according to the Chandler classification: stage I (3 cases), stage II (3 cases), stage III (15 cases), stage IV (8 cases). Antibiotic therapy was prescribed in all cases. Surgery was performed in 22 cases. Bacterial cultures revealed streptococcus (2 cases), aspergillus fumigatus (1 case) and were negative in 8 cases. The outcome was favorable in 27 cases. In two cases, the outcome was unfavorable with associated intracranial complications.
  
  
  CONCLUSIONS
  Oculoorbital extension of acute sinusitis is a diagnostic and therapeutic emergency. Paranasal sinus CT is essential to confirm orbital extension and identify the causative sinus. Intravenous antibiotic therapy is the main treatment. The roles of corticosteroid and heparin therapy remain controversial. Surgery is indicated in the case of abscess or high visual risk. Endoscopic endonasal surgery appears to have a double role, in diagnosis and treatment.
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie. Electronic address: houda.chahed@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Chahed
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: R
authors.initials: R
authors.lastname: Bachraoui
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: S
authors.initials: S
authors.lastname: Kedous
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: H
authors.initials: H
authors.lastname: Ghorbel
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Houcine
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: A
authors.initials: A
authors.lastname: Mediouni
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: J
authors.initials: J
authors.lastname: Marrakchi
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: R
authors.initials: R
authors.lastname: Zainine
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: M
authors.initials: M
authors.lastname: Ben Amor
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: N
authors.initials: N
authors.lastname: Beltaief
authors.affiliation: Service ORL et chirurgie maxillofaciale, hôpital de la Rabta, La Rabta Jebbari, 1007 Tunis, Tunisie.
authors.forename: G
authors.initials: G
authors.lastname: Besbes
mesh_terms: D000038:Abscess / Q000209:etiology / Q000628:therapy; D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D020226:Cavernous Sinus Thrombosis / Q000209:etiology / Q000628:therapy; D005094:Exophthalmos / Q000209:etiology / Q000628:therapy; D015818:Eye Infections, Bacterial / Q000209:etiology / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D015835:Ocular Motility Disorders / Q000209:etiology / Q000628:therapy; D054517:Orbital Cellulitis / Q000209:etiology / Q000628:therapy; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Antibiothérapie; Antibiotic therapy; Chirurgie; Endoscopie; Endoscopy; Orbitaire; Orbital; Sinusite; Sinusitis; Surgery