Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-18T18:14:26.825Z Has data issue: false hasContentIssue false

Paediatric orbital cellulitis and the relationship to underlying sinonasal anatomy on computed tomography

Published online by Cambridge University Press:  07 July 2017

R A Crosbie*
Affiliation:
Department of Paediatric Otorhinolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
W A Clement
Affiliation:
Department of Paediatric Otorhinolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
H Kubba
Affiliation:
Department of Paediatric Otorhinolaryngology, Royal Hospital for Children, Glasgow, Scotland, UK
*
Address for correspondence: Mr Robin Crosbie, Department of Paediatric Otorhinolaryngology, Royal Hospital for Children, Glasgow G51 4TF, Scotland, UK E-mail: robincrosbie@nhs.net

Abstract

Objective:

To assess if there is an association between sinonasal anatomical variants and the risk of developing orbital cellulitis and associated complications, in children.

Methods:

A retrospective case–control series was conducted, examining computed tomography confirmed sinonasal anatomical variants of septal deviation and concha bullosa in children who presented with periorbital cellulitis who went on to develop orbital cellulitis and abscesses.

Results:

Thirty children had a Chandler score of 2 or greater on computed tomography. Mean age was seven years and there was relatively equal sex distribution. There was no association between presence of concha bullosa and side of disease (odds ratio = 1), and no statistically significant difference between septal deviation and ipsilateral orbital infection (p = 0.125).

Conclusion:

There was no statistical correlation between any sinonasal bony or cartilaginous anatomical variants on computed tomography and orbital complications of acute rhinosinusitis in our paediatric cohort. The findings do not support the theory that these anatomical variants predispose to orbital cellulitis occurring in these children, nor complications thereof.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2017 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1 Crosbie, RA, Nairn, J, Kubba, H. Management of paediatric periorbital cellulitis: our experience of 243 children managed according to a standardised protocol 2012–2015. Int J Pediatr Otorhinolaryngol 2016;87:134–8Google Scholar
2 National Records of Scotland: Scotland's Census. In: http://www.scotlandscensus.gov.uk/ods-web/area.html [28 July 2016]Google Scholar
3 Chandler, JR, Langenbrunner, DJ, Stevens, ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 1970;80:1414–28Google Scholar
4 Brook, I. Acute sinusitis in children. Pediatr Clin North Am 2013;60:409–24Google Scholar
5 Magit, A. Pediatric rhinosinusitis. Otolaryngol Clin North Am 2014;47:733–46Google Scholar
6 Jackson, K, Baker, SR. Clinical implications of orbital cellulitis. Laryngoscope 1986;96:568–74Google Scholar
7 Oxford, LE, McClay, J. Complications of acute sinusitis in children. Otolaryngol Head Neck Surg 2005;133:32–7Google Scholar
8 Aramani, A, Karadi, RN, Kumar, S. A study of anatomical variations of osteomeatal complex in chronic rhinosinusitis patients – CT findings. J Clin Diagn Res 2014;8:14 Google Scholar
9 Orlandi, RR. A systematic analysis of septal deviation associated with rhinosinusitis. Laryngoscope 2010;120:1687–95Google Scholar
10 Grischkan, JM, Elmaraghy, CA, Garrett, MR, Karanfilov, BW, Jatana, KR. Radiographic findings and clinical correlates in pediatric periorbital infections. Int J Otorhinolaryngol 2015;2:5 Google Scholar
11 Karkos, PD, Karagama, Y, Karkanevatos, A, Srinivasan, V. Recurrent periorbital cellulitis in a child: a random event or an underlying anatomical abnormality. Int J Pediatr Otorhinolaryngol 2004;68:1529–32Google Scholar
12 Gray, LP. Deviated nasal septum: incidence and etiology. Ann Otol Rhinol Laryngol Suppl 1978;87:320 Google Scholar
13 Podoshin, L, Gertner, R, Fradis, M, Berger, A. Incidence and treatment of deviation of nasal septum in newborns. Ear Nose Throat J 1991;70:485–7Google Scholar
14 Kawalski, H, Spiewak, P. How septum deformations in newborns occur. Int J Pediatr Otorhinolaryngol 1998;44:2330 Google Scholar
15 van Cauwenberge, P, Derycke, A. The relationship between nasal and middle ear pathology. Acta Otorhinolaryngol Belg 1983;37:830–41Google Scholar
16 Song, SY, Kim, IT, Chang, KH, Lees, KS, Kim, HJ, Lim, HJ. The prevalence of nasal septal deformities among children in kindergarten and first grade in Anyang and Kunpo cities. J Rhinol 1999;6:5860 Google Scholar
17 Willner, A, Lazar, RH, Zalzal, GH. Endoscopic treatment of concha bullosa in children. Op Tech Otolaryngol Head Neck Surg 1996;7:289–92Google Scholar