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The Groote Schuur hospital classification of the orbital complications of sinusitis

Published online by Cambridge University Press:  29 June 2007

S. Mortimore  and
P. J. Wormald
S. Mortimore*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Groote Schuur Hospital, Cape Town, South Africa.
P. J. Wormald
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Groote Schuur Hospital, Cape Town, South Africa.
*
Address for correspondence: Mr S. Mortimore, Department of Otorhinolaryngology, Head and Neck Surgery, Whiston Hospital, Prescot, Merseyside L35 5DR.
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Abstract

The complications of sinusitis have been well described. The most common classifications used for orbital complications have been that of Chandler et al. (1970) and Moloney et al. (1987). With the ready availability of high-resolution computed tomography (CT) scanners, limitations of these classifications have become apparent. The aims of this study were to determine the relative frequency of the various complications associated with acute sinusitis, to determine which groups of sinuses were most frequently involved and to correlate the orbital signs with a new proposed classification of orbital complications. Over a five-year period, 87 consecutive patients were admitted with acute sinusitis. Sixty-three patients (72.4 per cent) had one or more complications. When orbital complications were classified under the proposed classification, all patients with proptosis and/or decreased eye movement had post-septal infection. Visual impairment occurred only in the post-septal group. Most complications had a combination of sinus involvement with the maxillary/ethmoid/frontal combination being the most common. The authors propose a modification of Moloney's classification for orbital complications of acute sinusitis that allows a clear differentiation between pre- and post-septal infection and a radiological differentiation to be made between cellulitis/phlegmon and abscess formation. The latter is of importance when a decision is made on whether surgical intervention is appropriate or not.

Keywords

Sinusitiscomplications
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 111 , Issue 8 , August 1997 , pp. 719 - 723
Copyright
Copyright © JLO (1984) Limited 1997

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