Orbital cellulitis complicating sinusitis: a 15-year review

Abstract

Background : Orbital cellulitis is an infection of the orbital soft tissues behind the orbital septum. Primary sinus infection is the most common cause of orbital cellulites. It is an ocular emergency that threatens not only vision but also life from complications such as meningitis, cavernous sinus thrombosis, and brain abscess. Method : A fifteen-year retrospective review (1986 – 2000) of all cases of orbital cellulitis, but with special focus on those of sinogenic origin seen at the University College Hospital, Ibadan, Nigeria. Results : Ninety patients were managed. There was a male preponderance (M: F ratio of 2:1) while 84% of the patients were below 20 years of age. Sinogenic orbital cellulitis constituted 57% of the study population (ninety cases) with the left orbit being involved most (55%), while the maxillary sinus had the highest incidence of sinusitis either singly (18%) or combined (65%). Complication of orbital cellulitis was found to be 52%, with no death but 11% became blind due to panophthalmitis. Conclusion : Though antibiotics have altered the course of sinusitis, its grave complications still persist in our environment. It is hoped that a well-structured health education/awareness programme and early referral to specialists will improve the final outcome.