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Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview

Otolaryngological Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, Italy
Department of Clinical Sciences and Community Health, University of Milan, 20122 Milan, Italy
Department of Physiopathology and Transplantation, University of Milan, 20122 Milan, Italy
Department of Otolaryngology-Head and Neck Surgery, Samson Assuta Ashdod University Hospital, Faculty of Health Sciences, Ben Gurion University, 7747629 Ashdod, Israel
Department of Clinical Microbiology, University of Milan, 20122 Milan, Italy
Author to whom correspondence should be addressed.
J. Clin. Med. 2019, 8(1), 101;
Received: 7 December 2018 / Revised: 9 January 2019 / Accepted: 14 January 2019 / Published: 16 January 2019
(This article belongs to the Special Issue Pediatric Rhinosinusitis and Asthma)
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Sinonasal-related orbital infections (SROIs) are typically pediatric diseases that occur in 3–4% of children with acute rhinosinusitis. They are characterised by various clinical manifestations, such as peri-orbital and orbital cellulitis or orbital and sub-periosteal abscesses that may develop anteriorly or posteriorly to the orbital septum. Posterior septal complications are particularly dangerous, as they may lead to visual loss and life-threatening events, such as an intracranial abscess and cavernous sinus thrombosis. Given the possible risk of permanent visual loss due to optic neuritis or orbital nerve ischemia, SROIs are considered ophthalmic emergencies that need to be promptly recognised and treated in an urgent-care setting. The key to obtaining better clinical outcomes in children with SROIs is a multi-disciplinary assessment by pediatricians, otolaryngologists, ophthalmologists, radiologists, and in selected cases, neurosurgeons, neurologists, and infectious disease specialists. The aim of this paper is to provide an overview of the pathogenesis, clinical manifestations, diagnosis, and treatment of pediatric SROIs, and to make some practical recommendations for attending clinicians. View Full-Text
Keywords: orbital cellulitis; children; rhinosinusitis; computed tomography orbital cellulitis; children; rhinosinusitis; computed tomography

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Torretta, S.; Guastella, C.; Marchisio, P.; Marom, T.; Bosis, S.; Ibba, T.; Drago, L.; Pignataro, L. Sinonasal-Related Orbital Infections in Children: A Clinical and Therapeutic Overview. J. Clin. Med. 2019, 8, 101.

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