[Acute ethmoiditis. A review of 38 cases]. / Etmoiditis aguda. Revisión de 38 casos.

ABSTRACT

OBJECTIVE: The purpose of this study was to assess the usefulness of computerized tomography (CT) scan in the diagnosis and management of the complications of acute ethmoiditis in children. MATERIALS AND METHODS: A retrospective revision of the records of pediatric patients admitted to Sant Joan de Déu Hospital from January 1985 to June 1994 was performed. RESULTS: Thirty-eight children (22 males and 16 females) between the ages of 18 months and 15 years (mean age 6.5 years) were studied. All of the patients had eyelid afflictions; 5 (13.2%) with eyelid edema and 33 (86.8%) with periorbital cellulitis. All of them were unilateral without side predominance. The signs and symptoms included fever (37) and orbital pain and headache (24), with 28 patients presenting other forms of sinusitis. CT scan was applied in 24 children (63%). Thirteen of these patients demonstrated complications of the orbit, 6 with orbital cellulitis, 4 subperiosteal abscess and 3 orbital abscesses. Surgery was performed in 3 cases. CONCLUSIONS: We conclude that the CT scan is a radiological procedure that must be applied when there are signs or symptoms compatible with orbital complications. Patients should also be scanned if their exam is worse or unchanged after 24-48 hours of antibiotic therapy. Early diagnosis and antibiotic treatment can prevent complications subsidiary of surgery.