Long-Term Outcomes of Orbital Complications in Pediatric Acute Sinusitis: A Retrospective Analysis

Introduction: The majority of complications from acute sinusitis in children involve the orbit and can have devastating consequences. There is a paucity of research exploring the risk of persistent or recurrent sinonasal disease after treatment in the pediatric population.

Methods: We performed a retrospective analysis of children diagnosed with acute sinusitis with orbital complications at a single tertiary care institution from January 2017 to June 2023. The electronic medical records were reviewed for the initial admission of acute sinusitis and post-discharge events, including readmission rate, length of follow-up period, antibiotic use, and the need for further surgery and/or imaging.

Results: Two hundred sixteen patients were included, with a mean age of 4.5 years. One hundred forty-six patients (67.6%) required medical treatment only for their acute episode, while the remaining 65 (32.4%) underwent at least one surgery. The readmission rate after discharge was 8.3% (n=18). Follow up data are available for 190 (88%) patients for an average of 213 days. Eighty-three of these patients (43.7%) followed up with otolaryngology, and the remaining data were captured from primary care or ophthalmology visits. Post-discharge,14% of patients (n=26) required additional antibiotics for sinusitis-related reasons. Most patients (n=158, 83%) did not require further surgery or imaging after discharge, indicating that the majority recovered without further complication. Eleven patients (5.8%) required sinus surgery within an average of 1.5 years after their initial admission for acute sinusitis.

Conclusions: The study findings show that orbital complications of acute sinusitis most often result in complete resolution of symptoms. Our data suggest that while some patients may require antibiotics for recurrent sinusitis, a small fraction will need further surgery or imaging.