Orbital complications of rhinosinusitis in pediatric practice

Background. Complications of acute rhinosinusitis remain a serious problem in pediatrics due to the high risk of adverse outcome. Despite the era of modern diagnostic methods, antibiotics, vaccines, the number of orbital complications of acute rhinosinusitis is not approaching zero.

Aim: to analyze the medical records of patients with orbital rhinosinusogenic complications and to identify factors contributing to the development of complications.

Materials and methods. A total of 37 medical records of patients aged 0 to 15 years with orbital complications of acute rhinosinusitis in 2023–2024, who received examination and treatment at the Kazan Children’s Republican Clinical Hospital, were retrospectively analyzed. The data were analyzed using the StatTech v. 4.2.6 program (developer — Stattech LLC, Russia).

Results and discussion. Treated in 2023. — 27 patients, in 2024 — 10 patients, 30% received antibacterial therapy at the prehospital stage. The median age of patients in the study was 6.97±4.04 years, patients aged 8 to 14 years prevailed (n=16). 27 boys (73%), 10 girls (27%) (p=0.012). Orbital complications are represented by subperiosteal orbital abscess (n=20, 54%) and preseptal cellulitis with reactive edema and eyelid hyperemia (46%, n=17). 67.6% of patients (n=25) were not vaccinated against S. Pneumoniae, 12 patients had at least one S. Pneumoniae vaccine (p=0.033). 9 patients (24.3%) were immunized against H. Influenzae, of which only 7 patients were immunized according to the full regimen.

Conclusions. The high-risk group includes children aged 0 to 7 years, especially boys. A decrease in the collective immunity of the pediatric population due to various reasons contributes to a more frequent incidence of acute rhinosinusitis. Endoscopic rhinosinussurgery minimizes surgical trauma and reduces the length of hospital stay. 70% of patients in the study did not receive antibiotics at the prehospital stage, adequate dosages of which should be considered an additional controllable factor preventing complications of acute rhinosinusitis.

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