title: Radiographic Findings and Clinical Correlates in Pediatric Periorbital Infections.
abstract: OBJECTIVE
  To review radiographic studies of pediatric patients presenting with periorbital infections and to evaluate sinonasal anatomical factors and clinical course related to this disease process.
  
  
  METHODS
  Retrospective study review of computed tomography (CT) scans in 100 patients less than 18 years old, admitted to a tertiary children's hospital with the diagnosis of an orbital infection. CT scans were reviewed for anatomic variants and Lund-Mackay scores were calculated. An independent chart reviews of the treatment course and need for surgical intervention was performed.
  
  
  RESULTS
  Of 100 patients, 67% were male, 60% had left-sided infections, and 30% of patients were treated with surgical drainage. Adenoid hypertrophy (61%), inferior turbinate hypertrophy (80%) and septal deviation (47%) were common, but did not show statistical correlation with the need for surgical intervention. Dehiscence of the lamina papyracea was identified in 21% of patients treated without surgery and in 76% of those requiring surgery (P 0.0048). The average overall Lund-Mackay score was 11.8 and did not correlate with the need for surgical intervention.
  
  
  CONCLUSIONS
  To our knowledge, this is the first study to evaluate the incidence of sinonasal anatomic abnormalities in children presenting with periorbital infections. This study also demonstrated that lamina papyracea dehiscence is a common finding and is associated with higher rates of surgical intervention. Such findings may have an important role in the diagnosis, surveillance and management of sinus disease in the pediatric population.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Wexner Medical Center at Ohio State University, Columbus, Ohio, USA.
authors.forename: Jonathan M
authors.initials: JM
authors.lastname: Grischkan
authors.affiliation: Department of Pediatric Otolaryngology, Nationwide Children's Hospital, Columbus, Ohio, USA.
authors.forename: Charles A
authors.initials: CA
authors.lastname: Elmaraghy
authors.affiliation: Ohio Sinus Institute, Columbus, Ohio, USA.
authors.forename: Matthew R
authors.initials: MR
authors.lastname: Garrett
authors.forename: Boris
authors.initials: B
authors.lastname: Karanfilov
authors.forename: Kris R
authors.initials: KR
authors.lastname: Jatana
keywords: Endoscopic sinus surgery; Lund-McKay; Periorbital cellulitis; Sinusitis; Subperiosteal abscess