A rare cause of ptosis in emergency medicine practice: acute sinusitis case report

Öz

Objective: Paranasal sinus infections are one of the most frequent causes of emergency service admissions. With increased incidence, complications are often local and classified according to the effecting side. Early identification of complication leads to reduce mortality and morbidity. Case: A 22 year old male patient was admitted to our emergency department with ptosis on his right eyelid. Firstly he was admitted to the family doctor and received oral cephalosporin treatment for upper respiratory tract infection. Within three days, the ptosis was progressively occurred. No additional systemic sign was detected. The eyelid has slightly edema, not have redness, conjunctival hyperemia and loss of brow not observed. Eye movements were naturally, display pain in the outward view. For differential diagnosis central nervous system imaging was performed. Patient referred to otorhinolaryngology surgeon with prediagnosis of orbital cellulite and acute sinusitis. The patient was admitted to the otorhinolaryngology clinic for operation because of complicated sinusitis. Conclusion: In the presence of acute sinusitis, infections may enter the orbital periosteum and spread to neighboring tissues. Computed tomography is a highly effective imaging modality for the evaluation of both paranasal infections and their complications. Patients with orbital complications must be hospitalized and immediate intravenous antibiotic therapy should be started.

Anahtar Kelimeler

• paranasal sinus infection,orbital cellulite,ptosis

Kaynakça

1. 1. Moloney J R, Badham NJ, McRae A. The acute orbit, preseptal cellulitis, subperiosteal abscess and orbital cellulitis due sinusitis. J Laryngol Otol 1987;101:1
2. 2. Chandler JR, Langenbrunner DJ, Stevens ER. The pathogenesis of of orbital complications in acute sinusitis. Laryngoscope. 1970;80:1414–28.
3. 3. Spires JR, Smith RJ. Bacterial infections of the orbital and periorbital soft-tissues in children. Laryngoscope. 1986;96:763–8.
4. 4. Wolf SR, Gode U, Hosemann W. Endonasal endoscopic surgery for rhinogen intraorbital abscess: a report of six cases. The Laryngoscope 1996; 106:105-110.
5. 5. Watkins LM, Pasternack MS, Banks M, Kousoubris P, Rubin PAD. Bilateral Cavernous Sinus Thromboses and İntraorbital Abscesses Secondary to Streptococcus milleri. Ophthalmology 2003;110:569-574.
6. 6. Hytonen M, Atula T, Pıtkaranta A. Complications of Acute Sinusitis in Children.Acta Otolaryngol Suppl .2000;543:154-157.
7. 7. Johnson JT, Infections.In :Krause CJ,ed.Otolaryngology-Head and Neck Surgery, Second Edition.Mosby Year Book,1993:929-940
8. 8. Wormald PJ, Ananda A, Nair S. The modified endoscopic Lothrop procedure in the treatment of complicated chronic frontalsinusitis. Clin Otolaryngol Allied Sci. 2003 Jun;28(3):215-220.

9. 9. Bhargava D, Sankhla D, Ganesan A, Chand P. Endoscopic sinus surgery for orbital subperiosteal abscess secondary to sinusitis. Rhinology. 2001 Sep;39(3):151-155
10. 10. Arjmand EM, Lusk RP, Muntz HR. Pediatric sinusitis and subperiosteal orbital abscess formation: diagnosis and treatment. Otolaryngol Head Neck Surg. 1993 Nov;109(5):886-894.
11. 11. Younis RT, Lazar RH, Bustillo A, Anand VK. Orbital infection as a complication of sinusitis: are diagnostic and treatment trends changing? Ear Nose Throat J. 2002 Nov;81(11):771-775
12. 12. Battal Tahsin SOMUK, Emrah SAPMAZ,,Levent GÜRBÜZLER,a orbital complications of rhinosinusitis. Turkish J Rhinology 2016;5