Proptosis in children caused by sinonasal pathology: A retrospective study

Background: One of the most frequent clinical signs of orbital pathology is proptosis. Because of their close anatomical relationships, para nasal sinus or nasal pathologies can exhibit proptosis. Purpose: To report the 10-years experience of a tertiary medical center (Kasr Elainy hospital-Cairo University) with children presenting with proptosis due to nasal or sinus lesion. Patients and Methods: Patients were identified by file review. Data were collected on demographics, findings on ophthalmologic and imaging evaluations, etiology, treatment, and outcome. Results: The study included 209 patients suffering from proptosis due to nasal or sinus pathology. Age of the patients ranged from 40 days to 16 years. Complicated acute sinusitis with orbital cellulitis, subperiosteal or orbital abscess and allergic fungal sinusitis constituted 93.3% of the presenting cases. Allergic fungal sinusitis and complicated sinusitis with subperiosteal abscess showed statistically-significant association with necessity of surgical intervention; while complicated acute sinusitis with orbital cellulitis showed statistically-significant higher proportion of complete resolution on medical treatment. Both “acute invasive fungal sinusitis” and “Lymphoma” showed statistically-significant association with vision non-improvement. While complicated acute sinusitis with orbital abscess showed statistically-significant higher proportion of vision improvement. Conclusion: Many sinonasal lesions can present with proptosis in childeren. Inflammatory causes were the most common causes of proptosis in children in our study. Proptosis needs to be evaluated completely for proper management and to limit the morbidity associated with it.