Acute bacterial rhinosinusitis and its complications in our pediatric otolaryngological department between 1997 and 2006

Objective

A retrospective survey of the number, age, gender, month of admission, type of persistent acute bacterial rhinosinusitis and case history of pediatric patients who did not respond to conservative therapy, and of those who suffered from complications of acute sinusitis.

Methods

The case charts of all children (<19 years of age) admitted to our department between January 1, 1997 and December 31, 2006 with persistent acute bacterial rhinosinusitis that within 14-26 days against the course of appropriate conservative therapy have not recovered and complications of acute sinusitis were subjected to a retrospective review.

Results

Of the 339 patients 182 were admitted with persistent acute bacterial rhinosinusitis and did not respond to conservative therapy and 157 children were diagnosed with secondary complications of acute sinusitis. Males predominated overall (54.8%). The most endangered age range was between 3 and 6 years. The highest number of admissions occurred in March. The maxillary sinus was most frequently involved. Orbital complications were observed in 150 patients: 126 cases of preseptal cellulitis, 9 of orbital cellulitis, 4 of subperiosteal abscess, and 11 of orbital abscess. Further two children were diagnosed with intracranial complications, four patients presented with osteomyelitis and the remaining one exhibited mucocele. Streptococcus pneumoniae was the most commonly cultured pathogen. There were no mortalities, and morbidity occurred in only two cases. The topicality and importance of this subject are illustrated by taking into account of two cases.

Conclusions

The complications of acute rhinosinusitis are challenging, but the prognosis can be favorable. Early diagnosis and surgical drainage procedures in conjunction with aggressive medical management remain the standard of care for these critically ill patients.