Orbital complications of sinusitis: epidemiological study and evaluation of management

Abstract Background Orbital complications of sinusitis remain potentially life-threatening, particularly in children and young adults, due to anatomical predispositions. Objective To assess the epidemiology, clinical characteristics, and management outcomes of orbital complications of sinusitis among patients presented to a tertiary referral center. Methods This epidemiological study included 66 patients with orbital complications of sinusitis presented to Kasr Alainy University Hospitals over a 6-month duration. All cases had detailed history taking, otorhinolaryngologic and ophthalmologic examinations, nasal endoscopy, and CT imaging of the nose, paranasal sinuses, and orbits. Patients received standardized medical management consisting of triple antibiotics, topical agents, and supportive measures. Results The median age of cases was 8 years (range 4–43), with 95.5% being children; females constituted 53%. All patients initially presented with preseptal cellulitis. Subperiosteal abscess occurred in 10.6% and orbital abscess in 4.5%. No cases of orbital cellulitis or cavernous sinus thrombosis were detected. Nine patients (13.6%) required surgical intervention with functional endoscopic sinus surgery (FESS). Surgical need was significantly associated with age, existence of subperiosteal abscess, orbital abscess, reduced visual acuity, and impaired ocular motility ( p < 0.05). All patients recovered completely without residual complications on follow-up. Conclusion Orbital complications of sinusitis are most frequent in children, with preseptal cellulitis predominating. Although most patients respond well to aggressive medical treatment, surgical intervention is required in selected cases with abscess formation or visual impairment. Early diagnosis and multidisciplinary care are essential to optimize outcomes.