© Borgis - New Medicine 3/1999, s. 20-21
Wiesław Dobroś, Urszula Horbacewicz, Urszula Sydor
Complications of acute ethmoiditis in children
From the Department of Otolaryngology, Regional Hospital in Tarnów
Head: Wiesław Dobroś, M.D.
In the years 1994-1997 sixteen children aged 3 to 15 years were treated for acute ethmoiditis at the Department of Otolaryngology at the Regional Hospital in Tarnow. Antibiotic therapy, visual acuity assessment, ultrasonographic (USG) orbit examination and eventually computer tomography (CT) were applied as routine procedures. In four (25%) children complications such as orbital phlegmone (1 child), subperiosteal abscess (2 children), as well as epidural abscess (1 child) were discovered. They were treated by surgery resulting in total regression of symptoms. The remaining children underwent conservative treatment, with constant visual acuity monitoring. In children, acute ethmoiditis with rapidly growing symptoms is still an illness with numerous complications, despite advances in antibiotic therapy.
In spite of radical progress in antibiotic therapy, acute ethmoiditis in children is often burdened with numerous complications. During 1994-1997, 16 children between the ages of 3 to 15 were hospitalised in the Department of Otolaryngology at the Regional Hospital in Tarnow because of acute ethmoiditis accompanied by various degrees of blepharoedema (Table 1).
Table 1. Number of children with acute ethmoiditis and their age.
The group consisted of 10 child-ren with isolated ethmoiditis, and 6children with polysinusitis. The cases of isolated ethmoiditis were found in the younger group, whereas the cases of polysinusitis were found in the older group. The diagnoses were assessed on the basis of plain sinus film.
We found ethmoiditis more often in boys (12) than girls (4); collected material complications referred only to the male gender (4 boys).
Treatment was administered using intravenous antibiotics in maximal doses, mucolytics and local vasoconstricting drugs. Constant visual acuity monitoring (twice daily) including eyeground assessment, as well as ultrasonographic and eventually orbit computed tomography examination were applied as routine procedures. Complications were present in 4 children (25%): 3 children had orbit- and 1 intracranial (Table 2).
Table 2. Number and type of ethmoiditis complications in children.
|Treatment||Blepharoedema||Orbit subperiosteal abscess||Orbit phlegmone||Epidural abscess|
We found a relation between the duration of pre-hospital symptoms and the occurrence of complications.
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