A CLINICAL STUDY ON ORBITAL COMPLICATIONS OF NASAL AND PARANASAL SINUS DISEASES IN A TERTIARY GOVERNMENT HOSPITAL
Journal Title: Journal of Evidence Based Medicine and Healthcare - Year 2017, Vol 4, Issue 31
Abstract
BACKGROUND The orbit is an area of considerable interest to the otolaryngologist because of its close anatomical relationship to the Paranasal Sinuses (PNS). PNS may be involved in various types of pathology arising in the nose and paranasal sinuses. Surgical procedures of the nose and PNS may sometimes involve the orbit or its contents. Infections of the paranasal sinuses may spread to the orbit through suture lines, congenital or acquired bony dehiscence and retrograde thrombophlebitis and by bone necrosis or bony erosion. Neoplasms of the PNS also can involve the orbit. Hence, knowledge of the anatomy of the orbit is very important. The several of diseases of PNS in a tertiary hospital were included in the study and the data analysed. The aim of the study is to determine the type of orbital complications of nasal and paranasal sinus diseases and to evaluate the management protocol in orbital complications of nasal and paranasal sinus diseases. MATERIALS AND METHODS The study included forty patients (40) with orbital complaints of diseases of nose and PNS. These patients had CT scan evidence of invasion of the orbit. After laboratory, radiological study and wherever necessary HPE is done. The entire patient’s data was analysed. The orbital complications were classified and analysed. RESULTS Among the 40 patients, the age range was 10 to 80 years. 14 patients were females and 26 were males. 36 patients had symptoms pertaining to the orbit while 4 patients without. 26 patients underwent surgical management. 4 patients underwent medical treatment. 6 patients were treated with radiotherapy and chemotherapy. Among the 40 patients, 8 patients were diagnosed to have frontal mucocele, 8 patients with carcinoma of maxilla, 4 patients with inverted papilloma, 6 patients with lymphoma, 4 patients with osteomyelitis of the maxilla, 2 patients with osteomyelitis of the frontal bone, 4 patients with orbital cellulitis, 2 patients with mucormycosis and 2 patients with aspergillosis. Among the 18 patients presenting with neoplasia, 8 patients (44.44%) showed HPE of squamous. CONCLUSION The orbital complications of PNS diseases include chronic sinusitis, benign and malignant neoplasia and invasive and noninvasive fungal involvement of PNS. Vision was more affected in patients with fungal infection of the sinuses with orbital extension. CT scan is the mainstay in diagnosis of orbital involvement. In malignancies of the paranasal sinuses involving the orbit, an intraoperative assessment of involvement of the orbital periosteum and orbital contents is important in determining whether orbital exenteration should be added to total maxillectomy
Authors and Affiliations
Binu Raju George, Beena Oommen
Keywords
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- EP ID EP217950
- DOI 10.18410/jebmh/2017/352
- Views 83
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