Topic: ESOPRS 2021 ePoster sessions
Time: Sep 17, 2021 16:00 Amsterdam, Berlin, Rome, Stockholm, Vienna, 15:00 London
(plain text version here)
Clinical and Radiological Predictive Factors for Surgical Intervention in Pediatric Subperiosteal Orbital Abscess Secondary to Acute Rhinosinusitis
Author: Nimer Sayed Ahmad
ePoster Number: 241,00
Purpose
The study aims to assess clinical and imaging factors that predict surgical intervention in Pediatric Subperiosteal Orbital Abscess Secondary to Acute Rhinosinusitis
Methods
A retrospective study conducted over eight years (2016–2023) at a tertiary medical center. A total of 624 children with periorbital/orbital cellulitis secondary to acute rhinosinusitis were included. Patients with a history of facial trauma or insect bites were excluded. Orbital imaging was performed on 107 children, and 45 were diagnosed with SPOA (Chandler stage III). Patients diagnosed with SPOA were divided into two groups: conservative treatment (n=20) and surgical intervention (n=25). Clinical parameters such as age, fever, leukocyte count, C-reactive protein (CRP) levels, and neutrophil-to-lymphocyte ratio (NLR) were evaluated. Radiological parameters, including abscess volume, abscess dimentions and proptosis, were measured using three-dimensional imaging techniques. ROC curve analysis was performed to assess the discriminatory ability of predictive factors.
Results
Age, fever, leukocyte count, and CRP levels did not significantly differ between the surgical and conservative groups. However, NLR was significantly higher in the surgical group (8.1 vs. 3.64, p<0.001). Radiological findings showed that both absolute radiological proptosis (19 mm vs. 16.1 mm, p<0.001) and the difference in proptosis between the affected and fellow eyes (4 mm vs. 2.1 mm, p<0.001) were significantly greater in the surgical group. A relative abscess volume ≥0.11 mL was found to predict the need for surgery with a sensitivity of 88% and specificity of 85%. Anteroposterior (AP) and craniocaudal (CC) dimensions of the abscess were significantly larger in the surgical group.
Conclusion
NLR and radiological parameters, particularly proptosis and abscess volume, are valuable predictors of surgical intervention in children with SPOA. These findings suggest that combining clinical and radiological assessments can improve decision-making for treating pediatric orbital infections, potentially guiding timely surgical management.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Muhammad | Abumanhal | Tel Aviv Soursaky Medical Center |
| Igal | Leibovich | Tel Aviv Soursaky Medical Center |
| Anat | Bachar Zipori | Tel Aviv Soursaky Medical Center |
| Daphna | Mezad-Koursh | Tel Aviv Soursaky Medical Center |
| Dana | Niry | Tel Aviv Soursaky Medical Center |
| Ran | Ben Cnaan | Tel Aviv Soursaky Medical Center |
Abstract ID: 25-210
