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Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

47 patients with orbital complications resulting from acute sinusitis have been treated at the Freiburg ENT Department during the last seven years. Acute ethmoiditis predominated in children, while pansinusitis was more common in adults. Previous sinus surgery did not prevent orbital complications arising from the same sinus. Orbital involvement was classified into periostitis, subperiosteal abscess and orbital cellulitis. According to clinical findings, 44.7% of the patients were managed conservatively. Prognosis was best in periostitis, whereas consersative treatment was unsafe in orbital cellulits. Children usually respond well to appropriate antibiotic coverage but the occurrence of common upper respiratory or anaerobic pathogens should be kept in mind.
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PMID:[Surgical or conservative treatment in orbital complications of sinus inflammations (author's transl)]. 70 Nov 1

The clinical picture of an acute orbit, as manifest by preseptal cellulitis, subperiosteal abscess or orbital cellulitis, is still frequently seen in ENT practice. The commonest cause is sinusitis and the authors advocate early surgical intervention in acute orbits due to sinusitis. Clinically, it can be difficult to distinguish between a subperiosteal abscess and orbital cellulitis and a CAT scan may be helpful. Surgically, a subperiosteal abscess is the more important (and probably more frequent) entity as it may require drainage. It may be suspected in an acute orbit which progresses rapidly or fails to settle on treatment and it may require drainage to allow the condition to resolve and avoid potentially damaging sequelae. A classification of the stages of the inflammatory processes seen in the acute orbit is given and the management of 34 cases due to sinusitis is discussed. The other causes of acute orbits are discussed and the further complications that may occur are also mentioned. Blindness, cavernous sinus thrombosis and cerebral involvement are still frequently recorded and death may still occur.
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PMID:The acute orbit. Preseptal (periorbital) cellulitis, subperiosteal abscess and orbital cellulitis due to sinusitis. 347 26

Despite modern antibiotics, frontal sinus abscess (and secondary orbital cellulitis) remains relatively common and potentially life-threatening. The declining incidence of chronic middle ear disease in the UK has made it one of the commonest causes of intracranial abscess. The speed with which suppuration can penetrate the sinus walls remains poorly understood and a research challenge. Management is best supervised by an ENT surgeon because the key decision is the timing of sinus surgery. The ENT surgeon, nevertheless, must be alert to the indications for consultation with neurosurgical colleagues. This paper aims to give an illustrated account of the clinico-pathological features and current management.
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PMID:Frontal sinus abscess and secondary orbital cellulitis. 383 23

Acute sinusitis is often a mild, self-limiting disease. However, in some cases, especially among children, sinusitis may become a severe, even life-threatening, disease. To examine the nature of complications of acute sinusitis, we studied the cases of children treated at the Helsinki University ENT Hospital, because of a complication caused by acute sinusitis from January 1997 to September 1998. There were 12 children (4 girls, 8 boys), whose ages ranged from 16 months to 16 years. One child had an epidural abscess, one got meningitis and cavernous sinus thrombosis, five had orbital cellulitis, one of whom lost her vision permanently in one eye, and five had preseptal cellulitis. All the children were treated with intravenous antibiotics and all, except the youngest, were treated with a direct sinus puncture. An operation (intranasal antrostomy, orbital drainage, functional endoscopic sinus surgery or adenoidectomy) was performed on six patients. In the majority of children, acute sinusitis is a mild self-limiting disease. However, severe complications still exist. When a complication of sinusitis is suspected, it is of utmost importance that the child be sent immediately to a hospital for proper diagnosis and treatment.
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PMID:Complications of acute sinusitis in children. 1090 7

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria, Candida, Aspergillus, etc. Fungal infections of the sinuses (inc. Aspergillus and Rhizopus spp.) may be particularly devastating, with rapid spread to involve bone and the central nervous system. Another classical presentation, which may present to ENT doctors, is that of bilateral parotid enlargement, especially in children who are 'slow progressors', many of whom also have Lymphoid Interstitial Pneumonitis (LIP). A major attitudinal change has occurred due to advances in 3 main areas: (i) the multidisciplinary management of the infected mother (inc. counselling, antenatal screening, elective caesarean section, advising against breast feeding, etc.), (ii) the prevention of vertical transmission, using anti-retroviral therapy to the infected mother during pregnancy, and to the potentially infected infant in the first weeks of life, and (iii) major advances due to the advent of highly active anti-retroviral treatment. With effective use of these measures, transmission rates may be reduced to <2%. None of the measures though, affect a cure, and it will still be many years before the development of effective vaccines. ENT doctors may be referred children already known to be HIV-positive. Knowing how to talk to infected children (and their parents) is full of potential pitfalls, and requires careful forethought. Many infection-control policies have required considerable rethinking due to the AIDS epidemic. This has especially been the case with respect to needle-stick injuries, post-exposure prophylaxis, sterilization and re-use of equipment, and safe approaches to surgery.
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PMID:HIV infection in children--impact upon ENT doctors. 1466 74

The study aimed at finding out the clinicopathologic, ophthalmic and visual profiles, management and outcome of mucoceles of the paranasal sinuses in Nigerians. The study was a retrospective review of 20 cases of mucoceles who presented to the ENT clinic and referred to the eye clinic of the University College Hospital Ibadan, Nigeria. These included nine males and 11 females with a male:female ratio of approximately 1:1. Mucoceles commonly involved more than one sinus on the same side. The sinuses commonly involved were the frontoethmoidal sinuses, frontal sinus and maxillary sinuses. The preoperative visual acuity in 16 (80%) patients was 6/4-6/9, three (15%) had between 6/9-6/18, and one (5%) patient was CF ("count fingers") in the affected eyes. The majority (90%) of our patients presented with multiple ophthalmic features; however, proptosis was the most popular and ophthalmic presentation and occurred in 15 (75%) patients. Proptosis was nonaxial in all cases with inferior, lateral or inferolateral displacement. Degree of proptosis ranged from 1-20 mm. Other presentations were squint (leading to diplopia) observed in one (5%) patient and epiphora in another [one (5%)] patient. Poor vision appeared to be the main problem in one (5%) patient, while in another [one (5%)] patient, the affected eye was completely immobilized. One (5%) patient presented with orbital cellulitis. Common radiological findings included classical expansive appearance with loss of the normal scalloping appearance with dehiscence of the wall of the affected sinus as was observed in nine (45%) of our patients. All 20 patients had excision of mucoceles (frontoethmoidectomies). At surgery, 11 (55%) patients had a combination of dehiscence of medial and/or posterior walls, and/or floor of the orbit. Materials evacuated were mucopurulent in 15 (75%) cases, moldy in three (15%) and cheesy in two (10%). Nine (45%) patients had intact walls. Three (15%) patients developed orbital cellulitis as postoperative complication. Postoperatively, proptosis regressed spontaneously within one week of surgery in 17 (85%) patients. By six weeks, all the patients had a complete regression of proptosis and visual acuity returned to preoperative visual acuity level except the patient with preoperative visual acuity of CF. This patient later deteriorated and became NPL (no perception of light) in the affected eye. This was a peculiar case in that operative findings in this patient were suggestive of another coexisting pathology, which was later confirmed to be a non-Hodgkin's lymphoma of the orbit. After two months, only three (15%) reported back for follow-up. The study concluded that proptosis is a common feature of mucoceles of the paranasal sinuses and that visual affectation was rather uncommon. Also whilst mucopurulent materials formed the content of most mucoceles, surgical intervention caused proptosis to regress dramatically. However, due to the high default rate in our study, no categorical statement can be made about recurrence rate of these swellings.
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PMID:Clinicopathologic, ophthalmic, visual profiles and management of mucoceles in blacks. 1653 80

Orbital cellulitis is an acute inflammation of the orbital content with exophthalmos, chemosis, blepharedema, reduction of eyeball motility and generalized illness, occasionally with fever. It is predominantly transmitted from the ENT region and rarely occurs as a complication after a scleral buckling procedure. The patient concerned contracted orbital cellulitis many years after scleral buckling because the cerclage was infected. Alterations to the sclera with atrophy and thinning in the context of myopia were probably favorable factors for development.
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PMID:[Restricted eyeball with proptosis]. 2117 1

Sinus infections can be complicated by ocular infections and, in late phases, by brain parenchyma infection. The article debates the case of a 12-year-old patient suffering from paucisymptomatic maxillo-spheno-ethmoidal rhinosinusitis, which was later complicated by orbital cellulitis, ending with the development of a brain abscess. The treatment is complex, initially targeting the source of the infection through draining the collection by middle maxillary antrostomy and anterior posterior ethmoidectomy, then the ablation of the brain abscess and postoperatively with prolonged massive antibiotherapy. Abbreviation: URI = upper respiratory infection, CT = computer tomography, MRI = magnetic resonance imaging, BA = brain abscess, VAS = visual scale of pain, ENT = ear, nose, throat, RE VA = right eye visual acuity, RE = right eye, CSF = cerebrospinal fluid.
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PMID:Orbital cellulitis and brain abscess - rare complications of maxillo-spheno-ethmoidal rhinosinusitis. 2945 Mar 87