Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review
Background: Although they can occur at all ages, orbital (OC) and periorbital cellulitis (POC) prevail in the pediatric population. Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery re...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-09-01
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| Series: | Journal of Personalized Medicine |
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| Online Access: | https://www.mdpi.com/2075-4426/12/9/1527 |
| _version_ | 1797486018681634816 |
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| author | Elena Cantone Eva Piro Eugenio De Corso Claudio Di Nola Stefano Settimi Giusi Grimaldi Gaetano Motta |
| author_facet | Elena Cantone Eva Piro Eugenio De Corso Claudio Di Nola Stefano Settimi Giusi Grimaldi Gaetano Motta |
| author_sort | Elena Cantone |
| collection | DOAJ |
| description | Background: Although they can occur at all ages, orbital (OC) and periorbital cellulitis (POC) prevail in the pediatric population. Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery reserved only for more severe cases. However, there is still a lack of consensus on the clinical markers of a need for surgery. The aim of this systematic review was to identify clinical markers of a need for surgery in children with OC. Our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1289 articles finally screened. This resulted in 31 full texts that were included in a qualitative analysis. The results of this review suggest that in children aged over 9 years, large subperiosteal orbital abscesses (SPOAs), impaired vision, ophthalmoplegia, proptosis, elevated C-reactive protein (CRP) and absolute neutrophil counts (ANC), hemodynamic compromise, no clinical improvement after 48/72 h of antibiotic therapy, and a Chandler III score or higher are clinical markers of the need for surgery. However, most of the studies are observational and retrospective, and further studies are needed to identify reliable and repeatable clinical markers of the need for surgery. |
| first_indexed | 2024-03-09T23:28:06Z |
| format | Article |
| id | doaj.art-3c795e14cd89409e990283d93346f284 |
| institution | Directory Open Access Journal |
| issn | 2075-4426 |
| language | English |
| last_indexed | 2024-03-09T23:28:06Z |
| publishDate | 2022-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Personalized Medicine |
| spelling | doaj.art-3c795e14cd89409e990283d93346f2842023-11-23T17:14:40ZengMDPI AGJournal of Personalized Medicine2075-44262022-09-01129152710.3390/jpm12091527Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic ReviewElena Cantone0Eva Piro1Eugenio De Corso2Claudio Di Nola3Stefano Settimi4Giusi Grimaldi5Gaetano Motta6Department of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples “Federico II”, 80131 Naples, ItalyDepartment of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples “Federico II”, 80131 Naples, ItalyFondazione Policlinico Universitario A. Gemelli IRCCS, Head and Neck Surgery-Otorhinolaryngology, 00168 Rome, ItalyDepartment of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples “Federico II”, 80131 Naples, ItalyFondazione Policlinico Universitario A. Gemelli IRCCS, Head and Neck Surgery-Otorhinolaryngology, 00168 Rome, ItalyDepartment of Neuroscience, Reproductive and Odontostomatological Sciences-ENT Section, University of Naples “Federico II”, 80131 Naples, ItalyOtorhinolaryngology, Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania Luigi Vanvitelli, 80131 Naples, ItalyBackground: Although they can occur at all ages, orbital (OC) and periorbital cellulitis (POC) prevail in the pediatric population. Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery reserved only for more severe cases. However, there is still a lack of consensus on the clinical markers of a need for surgery. The aim of this systematic review was to identify clinical markers of a need for surgery in children with OC. Our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1289 articles finally screened. This resulted in 31 full texts that were included in a qualitative analysis. The results of this review suggest that in children aged over 9 years, large subperiosteal orbital abscesses (SPOAs), impaired vision, ophthalmoplegia, proptosis, elevated C-reactive protein (CRP) and absolute neutrophil counts (ANC), hemodynamic compromise, no clinical improvement after 48/72 h of antibiotic therapy, and a Chandler III score or higher are clinical markers of the need for surgery. However, most of the studies are observational and retrospective, and further studies are needed to identify reliable and repeatable clinical markers of the need for surgery.https://www.mdpi.com/2075-4426/12/9/1527orbital cellulitisperiorbital cellulitissubperiosteal abscessacute rhinosinusitischildrenFESS |
| spellingShingle | Elena Cantone Eva Piro Eugenio De Corso Claudio Di Nola Stefano Settimi Giusi Grimaldi Gaetano Motta Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review Journal of Personalized Medicine orbital cellulitis periorbital cellulitis subperiosteal abscess acute rhinosinusitis children FESS |
| title | Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review |
| title_full | Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review |
| title_fullStr | Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review |
| title_full_unstemmed | Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review |
| title_short | Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review |
| title_sort | clinical markers of need for surgery in orbital complication of acute rhinosinusitis in children overview and systematic review |
| topic | orbital cellulitis periorbital cellulitis subperiosteal abscess acute rhinosinusitis children FESS |
| url | https://www.mdpi.com/2075-4426/12/9/1527 |
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