A case of bilateral orbital complications in a child who required endoscopic sinus surgery

Abstract

We report a case of bilateral orbital complications caused by acute sinusitis. A 12-year-old boy presented with headache, fever, general fatigue, bilateral periorbital swelling, and decreased visual acuity. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a subperiosteal orbital abscess of the left orbit and bilateral orbital cellulitis. The patient was treated with intravenous antibiotics (Sulbactam Sodium, Ampicillin Sodium) for one day. But the fever persisted and the periorbital swelling worsened. We performed bilateral endoscopic sinus surgery and drained the subperiosteal abscess of the left orbit. The fever fell on the next day, bilateral periorbital swelling and visual acuity were improved, and the patient was discharged on postoperative day 14. Follow up CT showed repair of the medial wall of the left orbit and clear paranasal sinuses. Bilateral orbital complications caused by sinusitis is very rare, and the prompt surgical treatment is necessary when conservative antibiotics therapy in not effective.