ĐẶC ĐIỂM LÂM SÀNG, CẬN LÂM SÀNG CỦA BỆNH LÝ VIÊM MŨI XOANG CẤP BIẾN CHỨNG Ổ MẮT Ở TRẺ EM TẠI BỆNH VIỆN NHI TRUNG ƯƠNG

Abstract

Background: Acute rhinosinusitis is an acute inflammation of the nasal mucosa and the paranasal sinuses. It is a common condition in the field of Otorhinolaryngology. In the United States, it is estimated that approximately 5%–13% of children develop sinusitis. In Vietnam, the prevalence of sinusitis among children is estimated to be 6.3%–6.6%. If not diagnosed and treated promptly, acute sinusitis can progress and lead to severe complications such as soft tissue infection, osteitis, orbital complications, or intracranial complications, which may be life-threatening. Orbital complications occur due to the spread of infection from the paranasal sinuses to adjacent orbital tissues and represent the most common type of complication, accounting for approximately 80% of all cases. Therefore, early recognition of clinical and paraclinical manifestations for timely diagnosis and appropriate management plays a crucial role. Objectives: To describe the clinical characteristics and imaging features of acute rhinosinusitis with orbital complications in children treated at the Vietnam National Children’s Hospital from 2019 to 2025. This is a retrospective study. Results: Among 51 pediatric patients, males predominated (64.71%), with a mean age of 31.02 ± 36.52 months. The most common presenting symptom was periorbital swelling accompanied by fever (49.0%). According to Chandler’s classification, Grade I accounted for 52.94%, Grade II for 13.73%, Grade III for 31.37%, and Grade IV for 1.96%. Computed tomography (CT) findings revealed that inflammatory lesions were primarily located in the ipsilateral or bilateral ethmoid and maxillary sinuses (70.6%), consistent with the typical pattern of infection spreading from the anterior paranasal sinus system to the orbit. Conclusion: Acute rhinosinusitis complicated by orbital involvement in children predominantly affects younger age groups, with a male predominance. The main reasons for hospital admission were fever and periorbital swelling. The most common clinical manifestations included eyelid swelling, nasal obstruction, and purulent nasal discharge on the affected side or bilaterally, accompanied by moderate to high fever. On CT scan, Chandler grade II and III were the predominant classifications, with the maxillary and ethmoid sinuses being the most frequently involved sites. This study provides characteristic clinical and radiological data that may aid in early diagnosis and appropriate management of this condition.