Abstract
With the recent progress in the development of antibiotics, there has been reduction in the incidence of serious complications occuring subsequent to acute sinusitis in children, and therapy of the disease mainly comprises conservative treatment ; few reports describe cases requiring surgical treatment. However, we encountered a case of acute sinusitis complicated by orbital cellulitis of a one-year-old child in whom about one-month conservative treatment alleviated symptoms but intranasal examination revealed the presence of a pururent nasal discharge in the middle meatus and distinct pyocele-like shadow as depicted by CT scan. Using an endoscope, the fontanelle of the maxillary sinus was intranasally opened (middle meatal antrostomy) to release the purulent discharge. Two months later, healing was achieved with cavitary maxillary sinus being retained.
We believe that even in infants and children, endoscopic surgical treatment with minimum stress on nasal sinuses is effective when conservative treatment results in prolongation of the disease to make it chronic.
