Evidence map›Paper›PMID 42032515›Full record

ArticleBMC pediatrics2026

Early surgical intervention for orbital complications of pediatric acute rhinosinusitis: outcomes and algorithmic approach.

Majd Werda, Rania Kharrat, Omar Walha, Mohamed Amine Chaabouni, Malek Mnejja, Ilheme Charfeddine

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Article in BMC pediatrics, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

6 authors.

Majd WerdaENT department and research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia. werdamajd@gmail.com.
Rania KharratENT department and research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
Omar WalhaENT department and research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
Mohamed Amine ChaabouniENT department and research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
Malek MnejjaENT department and research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.
Ilheme CharfeddineENT department and research Laboratory LR23ES01, Habib Bourguiba University Hospital, University of Sfax, Sfax, Tunisia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundOrbital complications of acute rhinosinusitis (ARS) in children require prompt intervention, but consensus on optimal surgical timing and approach remains limited. This study defines evidence-based indications and evaluates outcomes of surgical management while proposing a severity-stratified algorithm to guide intervention.

methodsWe conducted a retrospective cohort study of 48 patients aged <15 years who underwent surgery for ARS-related orbital complications (47 subperiosteal abscesses [SPA], 1 orbital abscess) at a tertiary center. Surgical criteria included SPA >4 mm, visual impairment, or intravenous antibiotic failure. Approaches compared were purely endonasal (16.7%) versus combined endonasal/external drainage (83.3%). Outcomes included resolution rates and reoperations. Limitations included retrospective design and variability in preoperative antibiotic regimens.

resultsThe combined approach group had a 95.8% success rate (46/48 patients), with 2 cases requiring reoperation (4.2%). Exclusive endonasal drainage was successful in all 8 cases where applied. No permanent visual deficits or major complications occurred. Surgical outcomes were independent of preoperative antibiotic heterogeneity, though this variability precluded direct medical-surgical comparisons.

conclusionsSurgery for pediatric ARS-related orbital complications achieves excellent outcomes when guided by radiographic and clinical criteria. Combined drainage is reserved for extensive abscesses, while endonasal alone suffices for localized cases. These findings support a standardized algorithm (Figure 3) integrating abscess location, volume, and clinical progression to optimize care. Future prospective studies should address antibiotic protocol standardization.

Indexed as

AbscessAlgorithmsOrbital DiseasesRhinitisRhinosinusitisSinusitisAcute DiseaseAdolescentAnti-Bacterial AgentsChildChild, PreschoolDrainageFemaleHumansMaleRetrospective StudiesAnti-Bacterial AgentsChandler classificationEndoscopic surgeryOrbital complicationsPediatric rhinosinusitisSubperiosteal abscess

Identifiers

PMID42032515
PMCPMC13262417

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.