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| The clinical analysis of nasal orbital complications caused by nasal diseases in children |
| SHI Chenjie,CHEN Bobei. |
| Department of Otorhinolaryngology, the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325027, China |
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| Cite this article: |
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SHI Chenjie,CHEN Bobei.. The clinical analysis of nasal orbital complications caused by nasal diseases in children[J]. JOURNAL OF WEZHOU MEDICAL UNIVERSITY, 2024, 54(2): 151-155.
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Abstract Objective: To explore the clinical characteristics, imaging, diagnosis and treatment of nasal intraorbital complications caused by nasal diseases in children. Methods: Clinical data of 7 children with
nasogenic intraorbital complications admitted to the Second Affiliated Hospital & Yuying Children’s Hospital of Wenzhou Medical University from 2019 to 2023 were retrospectively analyzed. The clinical characteristics,diagnosis and treatment of the disease were investigated according to relevant medical history, physical examination and imaging data and the literature reviewed. Results: Of the 7 cases, 6 had orbital complications due to acute sinusitis, and 1 case had intraorbital and periorbital lesions due to nasal vestibulitis and nasal furuncle. The clinical manifestations of children in this group included redness and swelling around the eyes, pain, limited movement of eyeballs and eyelids, etc. Among them, 5 children with acute sinusitis had fever with the highest body temperature of 38-40 ℃, some accompanied by cough, headache, nasal congestion and runny nose. CT showed swelling of eyelid and periorbital soft tissue, and clear intraorbital structure in 3 cases and in 4 cases were found blurred edge of the orbital structure, disappearance of the normal structure, limited density or increased diffusion of the orbital space the varied degree of exophthalmosis and the thickened shadow of the internal rectus muscle. After admission, all the patients in this group were given symptomatic treatment such as antibiotics,glucocorticoid anti-inflammatory, proton pump inhibitor to preserve the stomach and cooling fluid, etc. Among them, 1 patient with rhinocorticoid and nasal furuncle was given the above drugs after the operation of nasal furuncle, and 1 patient with nasosinusitis and orbital cellulitis was given nasal endoscopy after conservative treatment failed. All the children were cured and discharged from hospital after 3-13 days of hospitalization.Conclusion: The nasal cavity and sinuses in the human body are adjacent to the orbital structures, and in children,whose bodies are still in the developmental stage, nasal diseases are more likely to invade orbital tissues.Unless diagnosed and treated promptly, it can lead to serious consequences. In principle, early anti-infection and anti-inflammatory therapy and unobstructed drainage should be initiated. If necessary, sinusotomy or orbital decompression surgery may be performed with the collaboration of ophthalmologists. For pediatric patients, the diagnosis and treatment should be focused on the prevention of disease progression, permanent visual loss and ntracranial complications.
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Received: 16 September 2023
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