Orbital complications of acute rhinosinusitis: a new classification

Braz J Otorhinolaryngol. Sep-Oct 2007;73(5):684-8. doi: 10.1016/s1808-8694(15)30130-0.


Rhinosinusitis is a severe sickness and may have serious complications. Orbital complications happen more often, due to anatomical particularities and are lethal in 5% of patients. They vary from inflammatory signs to proptosis, loss of ocular motility and blindness.

Aim: We propose a new classification of acute rhinosinusitis complications.

Methods: A review of 83 patients with CT scan and clinical reports. Patients were evaluated at HCFMRP-USP between 1995 and 2005 and were diagnosed with complicated rhinosinusitis.

Results: In sixty-six patients, were identified three types of orbital complications: orbital cellulitis (46.9%), subperiosteal abscess (40.9%) and orbital abscess (12.1%). Seventeen were considered as eyelid infections and excluded from this new classification system.

Conclusions: The existing classifications of orbital complications, as Chandlers, do not consider the orbits anatomical characteristics and became obsolete after the development of the CT scan. This study proposes a new, more objective classification to guide the physician in establishing lines of conduct for each case.

MeSH terms

  • Abscess / diagnostic imaging
  • Abscess / etiology*
  • Acute Disease
  • Adolescent
  • Adult
  • Aged
  • Cellulitis / diagnostic imaging
  • Cellulitis / etiology*
  • Child
  • Child, Preschool
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Middle Aged
  • Orbital Diseases / classification
  • Orbital Diseases / diagnostic imaging
  • Orbital Diseases / etiology*
  • Retrospective Studies
  • Rhinitis / complications*
  • Rhinitis / diagnostic imaging
  • Sinusitis / complications*
  • Sinusitis / diagnostic imaging
  • Tomography, X-Ray Computed