ENDONASAL ENDOSCOPIC SURGERY IN CHILDREN WITH PERIORBITAL CELLULITIS

Ano: 2013 | Volume: 17 | Número: Suplemento

Autores: Tinoco P, Saraiva AA, Brito LBA, Tinoco MBO, Tinoco SBO, Lacerda VLC, et al.

Resumo Inglês:

Purpose: To report a case of periorbital cellulitis and a satisfactory outcome. CASE REPORT: Accompanying reports that a 9-year-old male child presented with intense frontal headache and fever, another clinic diagnosed him with a viral infection and prescribed symptomatic medicines. After 2 days, he sought treatment at HSJA with worsening clinical symptoms, a high fever, headache, nasal obstruction, and left palpebral edema associated with pain and local erythema, but with preservation of visual acuity. A hemogram was performed with leukocytosis, and CT of the paranasal sinuses showed thickening of the frontal sinus mucosa and opacification of the left ethmoid, maxillary, and sphenoid sinuses. The patient was hospitalized, and underwent treatment with intravenous antibiotics and corticosteroids for 2 days. Without clinical improvement, the patient underwent bilateral maxillary, ethmoid, and sphenoid endoscopic endonasal surgery. The patient recovered with a satisfactory follow-up in the postoperative period. CONCLUSION: Complications of acute rhinosinusitis may include infectious processes extending beyond the nasosinusal mucosa and affecting the orbit. More common in children, complications can cause blindness, and even death. The clinical picture of acute rhinosinusitis includes edema at the inside corner of the eye, extending to the upper eyelid, and sometimes below. An eye examination is essential for diagnosis. The treatment is hospitalization with intravenous antibiotic therapy. Surgery is indicated when there is evidence of an abscess on CT, impairment of visual acuity, treatment failure, or clinical involvement of the contralateral eye. The patient progressed satisfactorily after surgery and is receiving outpatient treatment.