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Cohort studyBMC pediatrics · 2026

Early surgical intervention for orbital complications of pediatric acute rhinosinusitis: outcomes and algorithmic approach.

Majd Werda, Rania Kharrat, Omar Walha … Ilheme Charfeddine

OphthalmologyCohort study

Surgery for pediatric orbital complications of sinusitis succeeded in 95.8% of cases.

Early surgical intervention for orbital complications of pediatric acute rhinosinusitis: outcomes and algorithmic approach.

Majd Werda … Ilheme Charfeddine

BMC pediatrics · 2026

Background

Orbital complications of acute rhinosinusitis (acute rhinosinusitis) in children require prompt intervention, but consensus on optimal surgical timing and approach remains limited.

Methods

We conducted a retrospective cohort study of 48 patients aged <15 years who underwent surgery for acute rhinosinusitis-related orbital complications (47 subperiosteal abscesses [SPA], 1 orbital abscess) at a tertiary center.

n = 48 patients

Results

surgery cleared the infection in nearly all children treated

95.8%

Success rate

4.2%

Reoperation rate

More results

Exclusive endonasal drainage was successful in all 8 cases where applied.

No permanent visual deficits or major complications occurred.

Surgical outcomes were independent of preoperative antibiotic heterogeneity, though this variability precluded direct medical-surgical comparisons.

“

Conclusion · 1 of 3

Surgery for pediatric acute rhinosinusitis-related orbital complications achieves excellent outcomes when guided by radiographic and clinical criteria.

Conclusion · 2 of 3

Combined drainage is reserved for extensive abscesses, while endonasal alone suffices for localized cases.

Conclusion · 3 of 3

These findings support a standardized algorithm (Figure 3) integrating abscess location, volume, and clinical progression to optimize care. Future prospective studies should address antibiotic protocol standardization.

Post

Early surgical intervention for orbital complications of pediatric acute rhinosinusitis: outcomes and algorithmic approach.

Surgery for pediatric orbital complications of sinusitis succeeded in 95.8% of cases.

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