Publication:

Emergency endoscopic sinus surgery in pediatric complicated sinusitis: case insights and current evidence

Rhinosinusitis is an inflammation of the lining membranes of the nose and sinuses. Complications of rhinosinusitis, such as orbital and intracranial sepsis, are common in pediatric patients, which can be life-threatening if diagnosis and treatment are delayed. In this case series, we illustrate the emergency indications of functional endoscopic sinus surgery (FESS) in complicated rhinosinusitis in children diagnosed and treated at a tertiary hospital in Saudi Arabia. Three different cases of complicated rhinosinusitis with intraorbital and intracranial extension, including orbital abscess, invasive fungal granulomatous sinusitis with orbital extension, and optic nerve and frontal empyema secondary to frontal sinusitis. All cases were managed by a combination of medical treatment in the form of intravenous (IV) antibiotics and an urgent surgical debridement through functional endoscopic sinus surgery FESS to clean the sinuses, orbit, and brain. Postoperative CT scans confirmed no intraoperative or postoperative complications in all cases. Despite the wide use of antibiotics, the serious complications of sinusitis in children still exist. The management of such cases is usually through a combination of medical and surgical treatments. FESS in the pediatric population is a direct, safe, and practical approach in dealing with the serious complication of pediatric sinusitis with low morbidity and excellent outcomes.