儿童急性鼻窦炎眶并发症五例临床分析

Clinical analysis of orbital complications of acute pediatric sinusitis

目的探讨手术治疗儿童急性鼻窦炎合并严重眶并发症的疗效。方法回顾性分析2010年11月至2011年7月连续收治的5例保守治疗无效后行鼻内镜手术治疗的儿童急性鼻窦炎眶并发症患儿的临床资料。结果5例患儿中合并眶蜂窝织炎1例，眶骨膜下脓肿3例，眶内脓肿1例，患儿术后体温均恢复正常，眼部症状消失。复查CT或MRI见眶部及鼻部病变基本消失。结论对于保守治疗无效的儿童急性鼻窦炎眶并发症病例应尽早行内镜鼻窦手术清除病灶，手术安全且疗效确切。

Objective To investigate the treatment outcome of surgical intervention for orbital complications of acute pediatric sinusitis. Methods Five children with orbital complications of acute sinusitis were retrospectively reviewed. The patients underwent pediatric endoscopic sinus surgery （PESS） after conservative treatment failed. Results There were 1 case with orbital cellulitis, 3 cases with subperiosteal abscess and 1 case with orbital abscess. After operation, the body temperature in all 5 patients returned to normal and ocular symptoms disappeared. CT or MRI was rechecked after PESS. The imaging showed that the orbital and nasal lesions disappeared. Conclusions If conservative treatment fails, it is important to perform PESS for children with orbital complications of acute sinusitis to clean the focus of infection as soon as possible. The surgery is safe and effective.