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Orbital complications of acute rhinosinusitis: a new classification

Rhinosinusitis is a severe sickness and may have serious complications. Orbital complications happen more often, due to anatomical particularities and are lethal in 5% of patients. They vary from inflammatory signs to proptosis, loss of ocular motility and blindness. AIM: We propose a new classification of acute rhinosinusitis complications. METHODS: A review of 83 patients with CT scan and clinical reports. Patients were evaluated at HCFMRP-USP between 1995 and 2005 and were diagnosed with complicated rhinosinusitis. RESULTS: In sixty-six patients, were identified three types of orbital complications: orbital cellulitis (46. 9%), subperiosteal abscess (40. 9%) and orbital abscess (12.1%). Seventeen were considered as eyelid infections and excluded from this new classification system. CONCLUSIONS: The existing classifications of orbital complications, as Chandler’s, do not consider the orbit’s anatomical characteristics and became obsolete after the development of the CT scan. This study proposes a new, more objective classification to guide the physician in establishing lines of conduct for each case.

orbital abscess; orbital cellulitis; orbital complications; complicated acute rhinusinusitis


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