A descriptive study of the patients with orbital complication of acute and chronic sinusitis

Ahamed Nauphal Pullarat, Mohamed Faisal C. K., Muraleedhran P. Nampoothiri, Suma R.


Background: This is a descriptive study of all of the patients with orbital complication of acute and chronic sinusitis presented in ENT and Ophthalmology department, Government Medical College Calicut, Kerala from January 2013 to September 2014. The purpose of this study is to evaluate clinical and radiological presentation, outcome of treatment and postsurgical complications of diagnosed case of orbital complications of acute and chronic sinusitis.

Methods: All the patients were subjected to thorough clinical examination, ophthalmological evaluation and radiological evaluation. Computerized tomography of paranasal sinuses both axial and coronal planes, MRI in selected cases, histopathology, fungal culture, a semistructured proforma are the study tools in this study. All the patients in this study received appropriate medical and surgical treatment and done a follow up evaluation at first month and at 3 months.  

Results: Preseptal cellulitis is the most common complication in our study. Fungal sinusitis due to uncontrolled diabetes mellitus is the most common condition causing orbital complication in our study.

Conclusions: Strict diabetic control, appropriate surgical and medical management and a vigilant follow up resulted in good outcome.


Acute sinusitis, Chronic sinusitis, Preseptal cellulitis, Fungal sinusitis

Full Text:



Levon MN ,Shirley Pignatan. Acute sinusitis in children- a retrospective study of orbital complication. Rev Bras Otolaryngol 2007;73(1):81-5

Smith AT, Spencer JT. Orbital complications resulting from lesions of the sinuses. Ann Otol Rhinol Laryngol 1948; 57:5-27

Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 1970; 80:1414-28.

Complications of sinusitis Robert S and Richard Slim Scott- Brown’s Otolryngol Head Neck Surg 7th edition 1547

Schramm VL, Myers EN, Kennerdell JS. Orbital complications of acute sinusitis: evaluation, management and outcome. Otolaryngol 1977; 86:221-30.

Orbital cellulitis complicating sinusitis-a 15 year review Nwaorgu et al Nigerian journal of surgical research2004;6(1):14-16

Goldberg AN, Oroszlan G, Anderson TD. Complications of frontal sinusitis and their management. Otolaryngol Clin North Am 2001;34(1):211–25.

Chaudhry IA, Shamsi FA, Elzaridi E, Al-Rashid W, Al-Amri A, Al-Anezi F et a.l Outcome of treated orbital cellulitis in a tertiary eye care centre in the middle East. Ophthalmology. 2007;114(2):345–54

Gupta S, Goyal R, Gupta RK. Clinical presentation and outcome of the orbital complications due to acute infective rhinosinusitis.Indian J.Otolaryngol Head Neck Surg.2013;65(Suppl 2): 431-34

Hawkins DB, Clark RW. Orbital invol vement in acute rhinosinusitis. Lessons from 24 childhood patients. Clinical Pediatrics. 1977; 16: 464-71

Osguthorpe JD, Hochman M. Inflammatory sinus diseases affecting the orbit. Otolaryngol Clin North Am 1993;26(4):657–71.

Williams SR, Carruth JAS. Orbital infection secondary to sinusitis in children: diagnosis and management. Clin. Otolaryngol. 1992; 17: 550-57

Gillespie MB, O’Malley BW. An algorithmic approach to the diagnosis and management of invasive fungal rhinosinusitis in the immunocompromised patient. Otolaryngol Clin North Am 2000;33(2):323–34.

Herbrecht R, Denning DW, Patterson TF, et al. Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis. N Engl J Med 2002;347(6):408–15.

Rogers TR, Frost S. Newer antifungal agents for invasive fungal infections in patients with haematological malignancy. Br J Haematol 2009;144:629–41.