Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review
Background: Although they can occur at all ages, orbital (OC) and periorbital cellulitis (POC) prevail in the pediatric population. Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery re...
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| Veröffentlicht in: | Journal of personalized medicine 2022-09, Vol.12 (9), p.1527 |
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| creator | Cantone, Elena Piro, Eva De Corso, Eugenio Di Nola, Claudio Settimi, Stefano Grimaldi, Giusi Motta, Gaetano |
| description | Background: Although they can occur at all ages, orbital (OC) and periorbital cellulitis (POC) prevail in the pediatric population. Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery reserved only for more severe cases. However, there is still a lack of consensus on the clinical markers of a need for surgery. The aim of this systematic review was to identify clinical markers of a need for surgery in children with OC. Our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1289 articles finally screened. This resulted in 31 full texts that were included in a qualitative analysis. The results of this review suggest that in children aged over 9 years, large subperiosteal orbital abscesses (SPOAs), impaired vision, ophthalmoplegia, proptosis, elevated C-reactive protein (CRP) and absolute neutrophil counts (ANC), hemodynamic compromise, no clinical improvement after 48/72 h of antibiotic therapy, and a Chandler III score or higher are clinical markers of the need for surgery. However, most of the studies are observational and retrospective, and further studies are needed to identify reliable and repeatable clinical markers of the need for surgery. |
| doi_str_mv | 10.3390/jpm12091527 |
| format | Article |
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Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery reserved only for more severe cases. However, there is still a lack of consensus on the clinical markers of a need for surgery. The aim of this systematic review was to identify clinical markers of a need for surgery in children with OC. Our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1289 articles finally screened. This resulted in 31 full texts that were included in a qualitative analysis. The results of this review suggest that in children aged over 9 years, large subperiosteal orbital abscesses (SPOAs), impaired vision, ophthalmoplegia, proptosis, elevated C-reactive protein (CRP) and absolute neutrophil counts (ANC), hemodynamic compromise, no clinical improvement after 48/72 h of antibiotic therapy, and a Chandler III score or higher are clinical markers of the need for surgery. However, most of the studies are observational and retrospective, and further studies are needed to identify reliable and repeatable clinical markers of the need for surgery.</description><identifier>ISSN: 2075-4426</identifier><identifier>EISSN: 2075-4426</identifier><identifier>DOI: 10.3390/jpm12091527</identifier><identifier>PMID: 36143312</identifier><language>eng</language><publisher>Basel: MDPI AG</publisher><subject>Abscesses ; C-reactive protein ; Cellulitis ; Children ; Immune system ; Inflammation ; Leukocytes (neutrophilic) ; Medical imaging ; Meta-analysis ; Ophthalmoplegia ; Otolaryngology ; Pediatrics ; Pneumonia ; Population ; Precision medicine ; Radiation ; Review ; Rhinosinusitis ; Sinuses ; Surgery ; Systematic review ; Thrombosis ; Vaccines</subject><ispartof>Journal of personalized medicine, 2022-09, Vol.12 (9), p.1527</ispartof><rights>2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2022 by the authors. 2022</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c353t-736a9bfc0c4724880fd35550f4ec8407aad91513b62381c9991b10aa12a14fe43</citedby><cites>FETCH-LOGICAL-c353t-736a9bfc0c4724880fd35550f4ec8407aad91513b62381c9991b10aa12a14fe43</cites><orcidid>0000-0002-7389-2033 ; 0000-0001-5761-7018 ; 0000-0003-0104-1501</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504785/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC9504785/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,724,777,781,882,27905,27906,53772,53774</link.rule.ids></links><search><creatorcontrib>Cantone, Elena</creatorcontrib><creatorcontrib>Piro, Eva</creatorcontrib><creatorcontrib>De Corso, Eugenio</creatorcontrib><creatorcontrib>Di Nola, Claudio</creatorcontrib><creatorcontrib>Settimi, Stefano</creatorcontrib><creatorcontrib>Grimaldi, Giusi</creatorcontrib><creatorcontrib>Motta, Gaetano</creatorcontrib><title>Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review</title><title>Journal of personalized medicine</title><description>Background: Although they can occur at all ages, orbital (OC) and periorbital cellulitis (POC) prevail in the pediatric population. Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery reserved only for more severe cases. However, there is still a lack of consensus on the clinical markers of a need for surgery. The aim of this systematic review was to identify clinical markers of a need for surgery in children with OC. Our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1289 articles finally screened. This resulted in 31 full texts that were included in a qualitative analysis. The results of this review suggest that in children aged over 9 years, large subperiosteal orbital abscesses (SPOAs), impaired vision, ophthalmoplegia, proptosis, elevated C-reactive protein (CRP) and absolute neutrophil counts (ANC), hemodynamic compromise, no clinical improvement after 48/72 h of antibiotic therapy, and a Chandler III score or higher are clinical markers of the need for surgery. However, most of the studies are observational and retrospective, and further studies are needed to identify reliable and repeatable clinical markers of the need for surgery.</description><subject>Abscesses</subject><subject>C-reactive protein</subject><subject>Cellulitis</subject><subject>Children</subject><subject>Immune system</subject><subject>Inflammation</subject><subject>Leukocytes (neutrophilic)</subject><subject>Medical imaging</subject><subject>Meta-analysis</subject><subject>Ophthalmoplegia</subject><subject>Otolaryngology</subject><subject>Pediatrics</subject><subject>Pneumonia</subject><subject>Population</subject><subject>Precision medicine</subject><subject>Radiation</subject><subject>Review</subject><subject>Rhinosinusitis</subject><subject>Sinuses</subject><subject>Surgery</subject><subject>Systematic review</subject><subject>Thrombosis</subject><subject>Vaccines</subject><issn>2075-4426</issn><issn>2075-4426</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2022</creationdate><recordtype>article</recordtype><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNpVUU1LxDAQDaKoqCf_QMCjrOazHx4EKX6BurCr55CmUzdrm6xJu7I3f7otiuhcZph5897wBqFjSs44z8n5ctVSRnIqWbqF9hlJ5UQIlmz_qffQUYxLMkQmGUvILtrjCRWcU7aPPovGOmt0gx91eIMQsa_xE0CFax_wvA-vEDbYOjwNpe0GWOHbVTMsdNa7EXtl-g7wbGGdj9b10XY2jvhiYZsqgLvA0zWEtYUPrF2F55vYQTtsGzyDsXuIdmrdRDj6yQfo5eb6ubibPExv74urh4nhkneTlCc6L2tDjEiZyDJSV1xKSWoBJhMk1boaTKC8TBjPqMnznJaUaE2ZpqIGwQ_Q5Tfvqi9bqAy4LuhGrYJtddgor636P3F2oV79WuWSiDSTA8HJD0Hw7z3ETi19H9xws2IpTaQc_BxlTr9RJvgYA9S_CpSo8WPqz8f4FyFOiPc</recordid><startdate>20220918</startdate><enddate>20220918</enddate><creator>Cantone, Elena</creator><creator>Piro, Eva</creator><creator>De Corso, Eugenio</creator><creator>Di Nola, Claudio</creator><creator>Settimi, Stefano</creator><creator>Grimaldi, Giusi</creator><creator>Motta, Gaetano</creator><general>MDPI AG</general><general>MDPI</general><scope>AAYXX</scope><scope>CITATION</scope><scope>8FE</scope><scope>8FH</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>LK8</scope><scope>M7P</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-7389-2033</orcidid><orcidid>https://orcid.org/0000-0001-5761-7018</orcidid><orcidid>https://orcid.org/0000-0003-0104-1501</orcidid></search><sort><creationdate>20220918</creationdate><title>Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review</title><author>Cantone, Elena ; 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Acute rhinosinusitis (ARS) is the most frequent predisposing factor of OC. Recent literature has suggested a medical management approach for OC and POC, with surgery reserved only for more severe cases. However, there is still a lack of consensus on the clinical markers of a need for surgery. The aim of this systematic review was to identify clinical markers of a need for surgery in children with OC. Our systematic review, in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) process, yielded 1289 articles finally screened. This resulted in 31 full texts that were included in a qualitative analysis. 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| subjects | Abscesses C-reactive protein Cellulitis Children Immune system Inflammation Leukocytes (neutrophilic) Medical imaging Meta-analysis Ophthalmoplegia Otolaryngology Pediatrics Pneumonia Population Precision medicine Radiation Review Rhinosinusitis Sinuses Surgery Systematic review Thrombosis Vaccines |
| title | Clinical Markers of Need for Surgery in Orbital Complication of Acute Rhinosinusitis in Children: Overview and Systematic Review |
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