Clinical analysis of acute rhinogenic orbital cellulitis with middle turbinate concha bullosa in children: A case report

Orbital cellulitis resulting from sinusitis is a serious and potentially vision-threatening complication, typically caused by the spread of sinus inflammation to the soft tissues surrounding the eye. In children, especially those aged 5–15, the sinuses develop rapidly, and the mucous membranes are relatively delicate. As a result, infections are more likely to extend to the orbital region.This condition predominantly arises from ethmoid and maxillary sinusitis, attributable to the developmental sequence of sinuses in children. Variations in nasal anatomy, such as septal deviation, middle turbinate concha bullosa, and hypertrophy of the inferior turbinate, contribute to conditions warranting surgical intervention. This report discusses the diagnosis and management of rhinogenic orbital cellulitis with middle turbinate concha bullosa in a 13-year-old patient. Who failed response to treatment with compound tobramycin eye drops, clindamycin phosphate and dexamethasone sodium phosphate. After bacterial culture and antimicrobial susceptibility tests of nasal secretions, therapy was switched to ceftriaxone sodium and dexamethasone sodium phosphate. Functional endoscopic sinus surgery (FESS) was conducted subsequently. 8 days post-surgery, all clinical symptoms have disappeared. Effective antimicrobial therapy and timely surgical intervention are critical in the management of orbital cellulitis. For complex cases involving multiple organs or tissues, multidisciplinary management is essential to control disease progression, alleviate patient's symptoms and shorten disease duration.