Increasing Incidence of Orbital Complications of Acute Rhinosinusitis in the Post Coronavirus Disease 2019 Era: A Tertiary Referral Center Experience

Objective: The aim of this study was to analyze the epidemiology, presentations, management, and outcomes of patients with orbital complications of acute bacterial rhinosinusitis in the post coronavirus disease 2019 (COVID-19) era. Methods: This study included 34 patients with orbital complications of acute bacterial rhinosinusitis who were managed at our tertiary referral institute during 2.5 years (February 2021-August 2023). The treatment plan was tailored for every patient according to the disease extension. Results: Twenty-eight out of 34 patients (73.5%) in this series required surgical treatment. Six patients with a diagnosis of pre-septal cellulitis did not undergo surgery. The surgical approach was endoscopic in 21 patients and combined endoscopic with external approaches in the remaining 3 cases. Prognosis and outcomes were excellent, where vision improved and orbital swelling resolved in all patients. Conclusion: Orbital complications of acute bacterial rhinosinusitis are becoming increasingly common at our center in the post-COVID-19 era, although the precise reason for this temporal trend is unclear. Coronavirus disease 2019-related immunological drift and/or concurrent immune suppression may have a role.