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Erschienen in: European Archives of Oto-Rhino-Laryngology 8/2018

04.06.2018 | Head & Neck

Orbital infections: a complete cycle 7-year audit and a management guideline

verfasst von: Mihiar Sami Atfeh, Kathryn Singh, Hisham Saleh Khalil

Erschienen in: European Archives of Oto-Rhino-Laryngology | Ausgabe 8/2018

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Abstract

Objectives

Orbital infections are regularly encountered and are managed by various healthcare disciplines. Sepsis of the orbit and adjacent tissues can be associated with considerable acute complication and long-term sequelae. Therefore, prompt recognition and management of this condition are crucial. This article presents the outcomes of a 7-year complete cycle audit project and describes the development of the new local guideline on the management of orbital infections in our tertiary centre.

Methods

(1) A retrospective 5-year audit cycle on patients with orbital infections. (2) A review of available evidence on the management of orbital infections. (3) A new local multidisciplinary guideline on the management of orbital infections. (4) A retrospective 2-year second audit cycle to assess the clinical outcomes.

Results

Various disciplines intersect in the management of orbital infections. Standardising the management of this condition proved to be achievable through the developed guideline. However, room for improvement in practice exists in areas such as the promptness in referring patients to specialist care, the multidisciplinary assessment of patients on admission, and the improvement of scanning requests of patients.
Literatur
1.
Zurück zum Zitat Upile NS, Munir N, Leong SC et al (2012) Who should manage acute periorbital cellulitis in children? Int J Pediatr Otorhinolaryngol 76:1073–1077CrossRefPubMed Upile NS, Munir N, Leong SC et al (2012) Who should manage acute periorbital cellulitis in children? Int J Pediatr Otorhinolaryngol 76:1073–1077CrossRefPubMed
2.
Zurück zum Zitat Clarke W (2006) Differentiating orbital from periorbital cellulitis in children. Clin Surg Ophthalmol 24:316–321 Clarke W (2006) Differentiating orbital from periorbital cellulitis in children. Clin Surg Ophthalmol 24:316–321
3.
Zurück zum Zitat Baring DE, Hilmi OJ (2011) An evidence based review of periorbital cellulitis. Clin Otolaryngol 36:57–64CrossRefPubMed Baring DE, Hilmi OJ (2011) An evidence based review of periorbital cellulitis. Clin Otolaryngol 36:57–64CrossRefPubMed
4.
Zurück zum Zitat Beech T, Robinson A, McDermott AL at el (2007) Paediatric periorbital cellulitis and its management. Rhinology 45:47–49PubMed Beech T, Robinson A, McDermott AL at el (2007) Paediatric periorbital cellulitis and its management. Rhinology 45:47–49PubMed
5.
Zurück zum Zitat Goldman RD, Dolansky G, Rogovik AL (2008) Predictors for admission of children with periorbital cellulitis presenting to the pediatric emergency department. Pediatr Emerg Care 24:279–283CrossRefPubMed Goldman RD, Dolansky G, Rogovik AL (2008) Predictors for admission of children with periorbital cellulitis presenting to the pediatric emergency department. Pediatr Emerg Care 24:279–283CrossRefPubMed
6.
Zurück zum Zitat Lalwani AK (2008) Current Diagnosis & Treatment, Otolaryngology Head and Neck Surgery, 2nd edn. McGraw-Hill, New York Lalwani AK (2008) Current Diagnosis & Treatment, Otolaryngology Head and Neck Surgery, 2nd edn. McGraw-Hill, New York
7.
Zurück zum Zitat Lee KJ (2003) Essential otolaryngology head and neck surgery, 8nd edn. McGraw-Hill, New York Lee KJ (2003) Essential otolaryngology head and neck surgery, 8nd edn. McGraw-Hill, New York
8.
Zurück zum Zitat Nageswaran S, Woods CR, Benjamin DK Jr et al (2006) Orbital cellulitis in children. Pediatr Infect Dis J 25:695–699CrossRefPubMed Nageswaran S, Woods CR, Benjamin DK Jr et al (2006) Orbital cellulitis in children. Pediatr Infect Dis J 25:695–699CrossRefPubMed
9.
Zurück zum Zitat Bedwell J, Bauman NM (2011) Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg 19:467–473CrossRefPubMed Bedwell J, Bauman NM (2011) Management of pediatric orbital cellulitis and abscess. Curr Opin Otolaryngol Head Neck Surg 19:467–473CrossRefPubMed
10.
Zurück zum Zitat Chandler JR, Langenbrunner DJ, Stevens ER (1970) The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 80:1414–1428CrossRefPubMed Chandler JR, Langenbrunner DJ, Stevens ER (1970) The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 80:1414–1428CrossRefPubMed
11.
Zurück zum Zitat Fincham G, Bhutta MF (2009) Orbital cellulitis: assessment and management. Br J Hosp Med 70:M108–M110CrossRef Fincham G, Bhutta MF (2009) Orbital cellulitis: assessment and management. Br J Hosp Med 70:M108–M110CrossRef
12.
Zurück zum Zitat Ryan JT, Preciado DA, Bauman N et al (2009) Management of pediatric orbital cellulitis in patients with radiographic findings of subperiosteal abscess. Otolaryngol Head Neck Surg 140:907–911CrossRefPubMed Ryan JT, Preciado DA, Bauman N et al (2009) Management of pediatric orbital cellulitis in patients with radiographic findings of subperiosteal abscess. Otolaryngol Head Neck Surg 140:907–911CrossRefPubMed
13.
Zurück zum Zitat Robinson A, Beech T, McDermott AL et al (2007) Investigation and management of adult periorbital and orbital cellulitis. J Laryngol Otol 121:545–554PubMed Robinson A, Beech T, McDermott AL et al (2007) Investigation and management of adult periorbital and orbital cellulitis. J Laryngol Otol 121:545–554PubMed
14.
Zurück zum Zitat Huang SF, Lee TJ, Lee YS et al (2011) Acute rhinosinusitis—related orbital infection in pediatric patients: a retrospective analysis. Ann Otol Rhinol Laryngol 120:185–190CrossRefPubMed Huang SF, Lee TJ, Lee YS et al (2011) Acute rhinosinusitis—related orbital infection in pediatric patients: a retrospective analysis. Ann Otol Rhinol Laryngol 120:185–190CrossRefPubMed
15.
Zurück zum Zitat Seltz LB, Smith J, Durairaj VD et al (2011) Microbiology and antibiotic management of orbital cellulitis. Pediatrics 127:e566–e572CrossRefPubMed Seltz LB, Smith J, Durairaj VD et al (2011) Microbiology and antibiotic management of orbital cellulitis. Pediatrics 127:e566–e572CrossRefPubMed
16.
Zurück zum Zitat McKinley SH, Yen MT, Miller AM et al (2007) Microbiology of pediatric orbital cellulitis. Am J Ophthalmol 144:497–501CrossRefPubMed McKinley SH, Yen MT, Miller AM et al (2007) Microbiology of pediatric orbital cellulitis. Am J Ophthalmol 144:497–501CrossRefPubMed
17.
Zurück zum Zitat Cummings CW, Harker LA, Krause CJ, Richardson MA, Schuller DE, Krause CJ et al (1998) Cummings otolaryngology: head and neck surgery, 3rd edn. St. Louis, Mosby Cummings CW, Harker LA, Krause CJ, Richardson MA, Schuller DE, Krause CJ et al (1998) Cummings otolaryngology: head and neck surgery, 3rd edn. St. Louis, Mosby
18.
Zurück zum Zitat Rudloe TF, Harper MB, Prabhu SP et al (2010) Acute periorbital infections: who needs emergent imaging? Pediatrics 125:e719–e726CrossRefPubMed Rudloe TF, Harper MB, Prabhu SP et al (2010) Acute periorbital infections: who needs emergent imaging? Pediatrics 125:e719–e726CrossRefPubMed
19.
Zurück zum Zitat Gavriel H, Yeheskeli E, Aviram E et al (2011) Dimension of subperiosteal orbital abscess as an indication for surgical management in children. Otolaryngol Head Neck Surg 145:823–827CrossRefPubMed Gavriel H, Yeheskeli E, Aviram E et al (2011) Dimension of subperiosteal orbital abscess as an indication for surgical management in children. Otolaryngol Head Neck Surg 145:823–827CrossRefPubMed
20.
Zurück zum Zitat Reynolds DJ, Kodsi SR, Rubin SE et al (2003) Intracranial infection associated with preseptal and orbital cellulitis in the pediatric patient. J AAPOS 6:413–417CrossRef Reynolds DJ, Kodsi SR, Rubin SE et al (2003) Intracranial infection associated with preseptal and orbital cellulitis in the pediatric patient. J AAPOS 6:413–417CrossRef
21.
Zurück zum Zitat Ball S, Okonkwo A, Powell S et al. (2017) Revised orbital cellulitis management guidelines for adults and paeds. ENT, UK Ball S, Okonkwo A, Powell S et al. (2017) Revised orbital cellulitis management guidelines for adults and paeds. ENT, UK
22.
Zurück zum Zitat Mahalingam-Dhingra A, Lander L, Preciado DA et al (2011) Orbital and periorbital infections: a national perspective. Arch Otolaryngol Head Neck Surg 137:769–773CrossRefPubMed Mahalingam-Dhingra A, Lander L, Preciado DA et al (2011) Orbital and periorbital infections: a national perspective. Arch Otolaryngol Head Neck Surg 137:769–773CrossRefPubMed
23.
Zurück zum Zitat Dewan MA, Meyer DR, Wladis EJ (2011) Orbital cellulitis with subperiosteal abscess: demographics and management outcomes. Ophthalmic Plastic Reconst Surg 27:30–32CrossRef Dewan MA, Meyer DR, Wladis EJ (2011) Orbital cellulitis with subperiosteal abscess: demographics and management outcomes. Ophthalmic Plastic Reconst Surg 27:30–32CrossRef
24.
Zurück zum Zitat Dhillon N, Jones N, Fergie N (2010) Audit of management of periorbital cellulitis and abscess in a district general hospital and a tertiary referral centre, in line with published guidelines. J Laryngol Otol 124:636–640CrossRefPubMed Dhillon N, Jones N, Fergie N (2010) Audit of management of periorbital cellulitis and abscess in a district general hospital and a tertiary referral centre, in line with published guidelines. J Laryngol Otol 124:636–640CrossRefPubMed
25.
Zurück zum Zitat Howe L, Jones NS (2004) Guidelines for the management of periorbital cellulitis/abscess. Clin Otolaryngol 29:725–728CrossRefPubMed Howe L, Jones NS (2004) Guidelines for the management of periorbital cellulitis/abscess. Clin Otolaryngol 29:725–728CrossRefPubMed
26.
Zurück zum Zitat Atfeh M, Khalil H (2015) Orbital infections: five-year case series, literature review and guideline development. J Laryngol Otol 129:670–676CrossRefPubMed Atfeh M, Khalil H (2015) Orbital infections: five-year case series, literature review and guideline development. J Laryngol Otol 129:670–676CrossRefPubMed
Metadaten
Titel
Orbital infections: a complete cycle 7-year audit and a management guideline
verfasst von
Mihiar Sami Atfeh
Kathryn Singh
Hisham Saleh Khalil
Publikationsdatum
04.06.2018
Verlag
Springer Berlin Heidelberg
Erschienen in
European Archives of Oto-Rhino-Laryngology / Ausgabe 8/2018
Print ISSN: 0937-4477
Elektronische ISSN: 1434-4726
DOI
https://doi.org/10.1007/s00405-018-5025-1

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