Binu Raju George
BACKGROUND
The orbit is an area of considerable interest to the otolaryngologist because of its close anatomical relationship to the
Paranasal Sinuses (PNS). PNS may be involved in various types of pathology arising in the nose and paranasal sinuses.
Surgical procedures of the nose and PNS may sometimes involve the orbit or its contents. Infections of the paranasal sinuses
may spread to the orbit through suture lines, congenital or acquired bony dehiscence and retrograde thrombophlebitis and by
bone necrosis or bony erosion. Neoplasms of the PNS also can involve the orbit. Hence, knowledge of the anatomy of the
orbit is very important. The several of diseases of PNS in a tertiary hospital were included in the study and the data analysed.
The aim of the study is to determine the type of orbital complications of nasal and paranasal sinus diseases and to
evaluate the management protocol in orbital complications of nasal and paranasal sinus diseases.
MATERIALS AND METHODS
The study included forty patients (40) with orbital complaints of diseases of nose and PNS. These patients had CT scan
evidence of invasion of the orbit. After laboratory, radiological study and wherever necessary HPE is done. The entire patient’s
data was analysed. The orbital complications were classified and analysed.
RESULTS
Among the 40 patients, the age range was 10 to 80 years. 14 patients were females and 26 were males. 36 patients had
symptoms pertaining to the orbit while 4 patients without. 26 patients underwent surgical management. 4 patients underwent
medical treatment. 6 patients were treated with radiotherapy and chemotherapy. Among the 40 patients, 8 patients were
diagnosed to have frontal mucocele, 8 patients with carcinoma of maxilla, 4 patients with inverted papilloma, 6 patients with
lymphoma, 4 patients with osteomyelitis of the maxilla, 2 patients with osteomyelitis of the frontal bone, 4 patients with
orbital cellulitis, 2 patients with mucormycosis and 2 patients with aspergillosis. Among the 18 patients presenting with
neoplasia, 8 patients (44.44%) showed HPE of squamous.
CONCLUSION
The orbital complications of PNS diseases include chronic sinusitis, benign and malignant neoplasia and invasive and
noninvasive fungal involvement of PNS. Vision was more affected in patients with fungal infection of the sinuses with orbital
extension. CT scan is the mainstay in diagnosis of orbital involvement. In malignancies of the paranasal sinuses involving the
orbit, an intraoperative assessment of involvement of the orbital periosteum and orbital contents is important in determining
whether orbital exenteration should be added to total maxillectomy.
