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Opthalmic Complications of Sinusitis

Figures show an example of sinusitis complication. Conjunctival chemosis, corneal haziness, proptosis, limited eye movements, and impaired visual acuity can occur.  Endoscopic examination showed presence of mucopus over the left middle meatus region. 

CT-scan in axial view showing periorbital abscess formation (arrow) complicating left-sided acute ethmoiditis. E - eyeball. 

 

Pus drained (P) after lamina papyracea and mediao orbital periosteum opened.  EB - ethmoid bulla, MT middle turbinate (medialized).

 

Chandler classification [orbital complication of sinusitis] includes:

 

Group I - Inflammatory edema (preseptal cellulitis); normal visual acuity and extraocular movement.

 

Group II - Orbital cellulitis with diffuse orbital edema; no discrete abscess.

Group III - Subperiosteal abscess of the lamina papyracea with downward and lateral globe displacement.

Group IV - Orbital abscess with chemosis, ophthalmoplegia, and decreased visual acuity.

Group V - Cavernous sinus thrombosis with progressive bilateral chemosis, ophthalmoplegia, retinal engorgement, and loss of visual acuity, along with possible meningeal signs and high fever.

Otologic Complications of Sinusitis

 

Bilateral maxillary sinusitis.  Note absent right frontal sinus.

 Bilateral acute otitis media complicating sinusitis.

Above - left ear, below - right ear.

Pulmonary Complications of Sinusitis

                   Chronic Sinusitis                                     Bronchiectasis.

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