[Orbital complications of rhinosinusitis].

INTRODUCTION: Orbital complications were observed in 53 patients (1.35%, n=53/3912 of all treated patients; 11.04%, n= 53/480 of hospitalized patients). Complications in the orbit can occur in 3-5% of adults with the inflammatory condition of sinuses, while the percentage in children ranges from 0.5-8%. OBJECTIVE: The objective of our work was to determine the frequency of the occurence of orbital complications of the rhinosinal inflammatory origin in a group of adults and children. METHOD: The retrospective analysis of patients treated of rhinosinusitis in the period 1992 to 2007, in the Clinical Center in Kragujevac. RESULTS: In the period of 15 years, a total number of 3912 patients were treated for inflamatory conditions of paranasal cavities. Orbital complications were found in 53 patients (1.35%, n=53/3912 of all treated patients). The number of children showing orbital complications caused by rhinosinusitis was 0.79%, while the number of adults was 1,88%. Acute rhinosinusitis in children was manifested as orbital complication in 14 patients (n=14/15, 93.33%), while 33 adults (n=33/38, 86.84%) had the exarcerbation of the chronic rhinosinusitis at the time of diagnosis of orbital complication. 80% of examined children had the maxillary and ethmoid sinus infected (n=12/15), while the adults most often had polysinusitis (n=22/38, 57.89%). In the juvenile age the most frequent complication was the cellulitis of the orbite (n=7/15, 46.66%), while in the adults it was the subperiostal absces (n=14/38, 36.84%). The adults were mostly treated surgically (n=31/38, 81.58%), while the children were treated by using conservative treatment (n=13/15, 86.67%). There were no cases of mortality. CONCLUSION: The prevention of complications is based on the adequate and timely treatment of acute sinusitis in children, as well as the curative treatment of chronical processes in adults.

[Foreign bodies of the lower respiratory tract].

Aspiration of foreign bodies of the lower respiratory tract is the most common cause of accidental death in children under 6 years of age in the United States. The aim of the study was to actualize the problem of foreign bodies in modern society, to determine the most common types of foreign body, who and why usually aspires foreign body, whether the incidence is changing, and to define principles for optimal prevention. During our five-year study, we had 166 cases of aspiration of foreign bodies of the lower respiratory tract. The incidence is highest in children under three years of age (54.8%). Cough (94.6%) and breathing difficulties (78.9%) were the dominated symptoms. The majority of aspirated objects were grain (peanuts, walnuts, sunflower seeds)--29.5%. Localization of foreign bodies was mainly in the right and left main bronchus, and the most common complications were atelectasis and emphysema. All patients had undergone a rigid upper tracheobronchoscopy and foreign body was found in 80 patients (48%). There was no need to perform neither tracheotomy, nor any further surgical treatment, as for example thoracotomy, in any patient. Good education is the best prevention.

[A-mode ultrasonography and roentgenography in diagnosing chronic nonpolypoid maxillary rhinosinusitis].

OBJECTIVES: The aim is to demonstrate diagnostic alternatives for A-mode ultrasonography in examining chronic nonpolypoid rhinosinusitis, its implementation, as well as its advantages and disadvantages in regards to roentgenography. METHOD: The prospective research conducted included patients with chronic nonpolypoid rhinosinusitis, at 79 maxillary sinuses. Chronic diseases are classified into two separate categories depending on the clinical entity. Comparative analysis of the ultrasound and roentgenography findings was conducted for both, while the status of the maxillary sinuses obtained by sunusoscopy provided the gold standard. RESULTS: Generally speaking, the reliability of the A-mode ultrasonography in diagnosing chronic nonpolypoid diseases in maxillary sinuses was of a somewhat greater degree in comparison to roentgenography, amounting to 72.15% in relation to 60.76%. There is no statistically significant divergence in relation to the foregoing methods. A-mode ultrasonography is more helpful in the process of identifying liquid contents, and can be less utilized in identifying hypertrophic mucous membrane. CONCLUSION: Ultrasonography is efficient, economical and quite simple for the implementation. Its chief advantage is to be perceived in the fact that both the patient and the examiner avoid being exposed to ionized radiation. Ultrasonography and roentgenography suggest lesser degree of utility and represent a triage method in detecting chronic nonpolypoid pathological conditions.