Transnasal endoscopic treatment of orbital complications of acute sinusitis: the Graz concept.
OBJECTIVE
Orbital complications of acute sinusitis can be severe. Nowadays, surgical drainage of intraorbital abscess formations is performed endoscopically in the majority of cases. This study aims to illustrate the Graz experience in the endoscopic treatment of orbital complications and to present our treatment algorithm.


METHODS
In a retrospective study, 53 patients were examined who were referred to the Department of General Otorhinolaryngology of the ENT-University Hospital Graz from 2000 to 2011.


RESULTS
Of 53 patients, men were affected more frequently than women (n=37, 69.81% vs n=16, 30.19%). The following diagnoses were obtained: 9 preseptal cellulitis, 7 orbital cellulitis, 14 subperiosteal abscesses, and 23 orbital abscesses. In 16 patients, a conservative therapy was administered; 37 patients underwent surgery, most of them purely endoscopically (n=31, 83.78%). Two of the patients who underwent conservative treatment and 7 of those who underwent surgery experienced a recurrence (n=9, 16.98%).


CONCLUSIONS
Based on analysis of our recurrences, we have tried to create the optimal treatment algorithm as a point of reference in the management of orbital complications of acute sinusitis. In this way, 7 of 9 recurrences could have been avoided, equaling a hypothetical recurrence rate of 3.77% instead of 16.98% (hypothetical success rate 96.23%).
Department of General Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Graz, Austria.
Fabian
F
Teinzer
Department of General Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Graz, Austria.
Heinz
H
Stammberger
Department of General Otorhinolaryngology-Head and Neck Surgery, Medical University of Graz, Graz, Austria peter.tomazic@medunigraz.at.
Peter Valentin
PV
Tomazic
D000038:Abscess / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications* / Q000175:diagnosis; D014057:Tomography, X-Ray Computed
acute sinusitis; endoscopic transnasal treatment; orbital complications; treatment algorithm