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Research Article

The Complications of Sinusitis in a Tertiary


Care Hospital:
Types, Patient Characteristics, and Outcomes

Steven Lie11-2014-325
Mangara Wahyu Charros11-2015-207

DEPARTMENT OF ENT and Head & Neck Surgery


RS MARDI RAHAYU KUDUS
13 JUNE-16 JULY 2016

Abstract
Objective: To study the complications of sinusitis in a referral
hospital and the outcome of the treatment according to the type
of complication.
Methods: A retrospective study was performed on patients with
sinusitis who were admitted to a referral hospital from 2003 to
2012. The data for the sinusitis patients who had complications
were reviewed.
Results and Discussion: Eighty-five patients were included in the
study, of whom 50 were male (58.8%). Fourteen of the cases
were less than 15 years old, and 27 of the patients (31.7%) had
more than one type of complication. The most common
complication was of the orbital type (100% in the children, 38% in
the adults). After the treatment, all of the children and 45 of the
adults (63.4%) recovered, eight of the adult patients died
(11.3%), and 18 of the adults were cured with morbidity (25.3%).
Conclusion. The outcomes of the treatment depended on the
number and type of complications, with the poorest results
achieved in cases of intracranial complications.

The patients with more


numerous complications had
poorer outcomes. When the
types of complications were
compared (adjusted for age,
gender, and comorbidities)

The intracranial complication


was the only one that was
statistically significant for
mortality.

Re
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Ma
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Int
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Topic

Introduction
Sinusitis, which is a common ear, nose, and
throat disease, develops after a viral upper
respiratory tract infection in 0.52% of
patients. However, its complications are
unusual.

The complication rates of the patients


admitted with acute sinusitis varied
from 3.7 to 20%

Complications of sinusitis
Local 5-10%
Intrakranial (1520%)
Orbital (6075%)

Many studies have reported cranial nerve(s) palsy in the posterior


ethmoid or sphenoiditis
Optic neuropathy has been included in the complications of
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chronic sinusitis

Materials
Materials and
and Method
Method
A retrospective study was performed on
sinusitis patients
admitted to Chiang Mai University Hospital from
2003 to 2012. The data for the sinusitis
patients with complications and their operative
schedules were reviewed, gathered, and
grouped as follows.
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Statistical Analysis

The data for the patients


characteristics, the organisms involved,
and the outcomes of treatment were
gathered. The data were analysed using
the STATA program version 11.0

The data for the patients characteristics, the


organisms
involved, and the outcomes of treatment were
gathered.
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Results
Results
There were 146 suspected cases of
complications in the 1,655 admitted sinusitis
patients. Theremainder of the patients had
been admitted for sinus surgery due the failure
to medically control their sinusitis.

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Local

Complicatio
n

- Facial cellulitis,
abcesses
- Osteomyelitis
Mucocele/mucopyoce
le

Orbital

- Orbital
cellulitis
- Subperiosteal
abcesses

Intracrani
al

- Meningitis
- Dural sinus
thrombosis

Cranial
nerve
palsy
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The data for the patients characteristics, the


organisms
involved, and the outcomes of treatment were
gathered.
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Gender
50 males
(58,8%)
35 females
(35%)

Age
<15 yo ( 14
case, 16,5%)
Adults (71
case, 83,5%)

Underlying
condition
Diabetesmellitus
(18.8%),
chronic renal failure
(8.2%),
malignancy (5.9%),
chronic liver
disease (3.5%),
HIV infection
(2.4%).

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Types of complication classified by


age group

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Complication of sinusitis
29 cases
with local
Complicati
on

41 cases
Orbital
cellulitis

24 cases
intracrania
l

Facial cellulitis or an abscess was the


5 of the patients had more than one
most
common
complication
(15
cases),
A subperiosteal
was the
most
common
intracranialabscess
complication.
The
incidences
of
followed
by(IC)
mucocele
(12 by
cases)
complication
(16
cases),
followed
orbitaland
intracranial
complication
included
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cellulitis
(10ofcases),
periorbital
osteomyelitis
(2
cases).
cases
meningitis,
five brain abscesses
cellulitis
(eight cases),
sinus
(temporal,
frontal,cavernous
midbrain and
pons,
thrombosis
(sixand
cases),
epidural,
along the superior sagittal
and orbital
(1 case).
sinus),abscess
and eleven
cases with dural venous
sinus thrombosis

15 case patient of CN palsy without other types of


complications
9 of the
patients
had
isolated
unilateral
or
bilateral
sphenoidi
tis

4 patients
had
pansinusit
is that
also
involved
the
sphenoid
sinus

1 patient
had
ethmoiditi
s

1 patient
had both
maxillary
sinusitis
and
frontal
sinusitis.

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Discussion
Discussion
Type of comparison of the
types of complication in the
different age group, sex
distribution

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Orbital cellulitis and


subperiosteal
abscesses were more
commonly found than

The second most


common
complication in this
study was cranial
nerve(s) palsy

Discussion
This difference in findings
Followed by local
complications

may be explained by the


high proportion of adults
in this study, the severity
of the disease, and the
sinus cases that required
surgical referrals,

Conclusion
Conclusion
The orbital complication was the most
common complication in both children and
adults. Additionally, in adult patients, Cranial
Nerve palsy occurred either alone or in
combination with other types of complications.
The outcomes of the treatment depended on
the number and types of the complications,
with the poorest results occurring in the cases
with Intra Cranial complications.
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