{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,5]],"date-time":"2026-05-05T10:13:19Z","timestamp":1777975999471,"version":"3.51.4"},"reference-count":24,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T00:00:00Z","timestamp":1765497600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2026,5]]},"abstract":"ABSTRACT<\/jats:title>\n \n Objectives<\/jats:title>\n \n Orbital infections of acute rhinosinusitis are commonly classified thanks to the Chandler classification and may lead to vision loss or diplopia if not properly managed. While pediatric cases are well documented and their management is supported by clear evidence, data guiding adult management remain limited and fragmented. This study analyzes a large international cohort of patients that evaluates treatment approaches and outcome predictors for orbital complications (\n OCs<\/jats:styled-content>\n ) of acute sinusitis in adulthood.\n <\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n This multicentric retrospective study included adults with\n OCs<\/jats:styled-content>\n of acute sinonasal infections. Patients were classified using the Chandler classification, with an additional subdivision for pre\u2010septal infections (modified Chandler classification). Clinical, radiologic, and therapeutic data were analyzed, evaluating treatment success, hospital stay, and complications. Predictors of treatment and outcomes were studied (\n p<\/jats:italic>\n \u2009<\u20090.05).\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 213 patients (65.3% male, median age 48), 68.2% required surgery, mainly endoscopic (60.7%). Logistic regression identified the presence of additional complications (\n p<\/jats:italic>\n \u2009=\u20090.015) and modified Chandler classification (\n p<\/jats:italic>\n \u2009<\u20090.001) as the strongest predictors for treatment modality, while sinus opacification and visual impairment lost significance in the multivariate model. Infection resolution after primary treatment was significantly associated with nasal corticosteroid use (\n p<\/jats:italic>\n \u2009=\u20090.037). Despite differences in treatment approach and hospitalization duration across modified Chandler categories, no significant differences were observed in final ophthalmologic outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n \n This study emphasizes the role of the modified Chandler classification for upfront treatment decisions. Abscess\u2010related and type\n II OCs<\/jats:styled-content>\n often needed surgery, yet all cases achieved similarly optimal ophthalmologic outcomes and final infectious resolution.\n <\/jats:p>\n <\/jats:sec>\n \n Level of Evidence<\/jats:title>\n 4.<\/jats:p>\n <\/jats:sec>","DOI":"10.1002\/lary.70309","type":"journal-article","created":{"date-parts":[[2025,12,13]],"date-time":"2025-12-13T05:01:22Z","timestamp":1765602082000},"page":"2073-2081","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Orbital Complications of Acute Rhinosinusitis in Adulthood: Predictors of Outcome and Management"],"prefix":"10.1002","volume":"136","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4805-4908","authenticated-orcid":false,"given":"Alessandro","family":"Vinciguerra","sequence":"first","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, ASST Lariana Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0901-6266","authenticated-orcid":false,"given":"Vittorio","family":"Rampinelli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3678-9088","authenticated-orcid":false,"given":"Mario","family":"Turri\u2010Zanoni","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, ASST Lariana Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4023-0121","authenticated-orcid":false,"given":"Marco","family":"Ferrari","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery Azienda Ospedale\u2010Universit\u00e0 Padova Padova Italy"},{"name":"Section of Otorhinolaryngology\u2014Head and Neck Surgery, Department of Neuroscience (DNS) University of Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8708-8716","authenticated-orcid":false,"given":"Marco","family":"Valentini","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, ASST Lariana Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8916-6562","authenticated-orcid":false,"given":"Alberto Daniele","family":"Arosio","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, Ospedale di Circolo Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Federico","family":"Raimondi","sequence":"additional","affiliation":[{"name":"Respiratory Medicine Unit ASST Papa Giovanni XXIII Bergamo Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7558-339X","authenticated-orcid":false,"given":"Florian","family":"Chatelet","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Skull Base Center, AP\u2010HP, Hospital Lariboisi\u00e8re Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefano","family":"Taboni","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery Azienda Ospedale\u2010Universit\u00e0 Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7023-6746","authenticated-orcid":false,"given":"Davide","family":"Mattavelli","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1580-3928","authenticated-orcid":false,"given":"Alberto","family":"Schreiber","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-591X","authenticated-orcid":false,"given":"Fabio","family":"Sovardi","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Fondazione I.R.C.C.S. Policlinico San Matteo Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Barucco","sequence":"additional","affiliation":[{"name":"Skull Base and Rhino\u2010Orbital Surgery Unit Azienda Ospedaliero\u2010Universitaria Pisana Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4192-8353","authenticated-orcid":false,"given":"Lorena","family":"Di Girolami","sequence":"additional","affiliation":[{"name":"Skull Base and Rhino\u2010Orbital Surgery Unit Azienda Ospedaliero\u2010Universitaria Pisana Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6219-9180","authenticated-orcid":false,"given":"Piergiorgio","family":"Gaudioso","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery Azienda Ospedale\u2010Universit\u00e0 Padova Padova Italy"},{"name":"Section of Otorhinolaryngology\u2014Head and Neck Surgery, Department of Neuroscience (DNS) University of Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3687-8814","authenticated-orcid":false,"given":"Antonio","family":"Daloiso","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery Azienda Ospedale\u2010Universit\u00e0 Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Dan\u00e8","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Umberto","family":"Tanzini","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola","family":"Tessari","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery Azienda Ospedale\u2010Universit\u00e0 Padova Padova Italy"},{"name":"Section of Otorhinolaryngology\u2014Head and Neck Surgery, Department of Neuroscience (DNS) University of Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jessica","family":"Zuppardo","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery IRCCS Humanitas Research Hospital Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kays Burak","family":"Cakir","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine Istanbul University\u2014Cerrahpasa Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5734-9751","authenticated-orcid":false,"given":"Yetkin Zeki","family":"Yilmaz","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine Istanbul University\u2014Cerrahpasa Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yasar","family":"Unlu","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Faculty of Medicine Erciyes University Kayseri Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Ronchi","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, Ospedale di Circolo Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stefania","family":"Gallo","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, Ospedale di Circolo Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Francesca","family":"De Bernardi","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, Ospedale di Circolo Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vasileios","family":"Chatzinakis","sequence":"additional","affiliation":[{"name":"Medical School University of Nicosia Nicosia Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Argyro","family":"Leventi","sequence":"additional","affiliation":[{"name":"Medical School University of Nicosia Nicosia Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabio","family":"Pagella","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Fondazione I.R.C.C.S. Policlinico San Matteo Pavia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0611-4570","authenticated-orcid":false,"given":"Benjamin","family":"Verillaud","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Skull Base Center, AP\u2010HP, Hospital Lariboisi\u00e8re Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giuseppe","family":"Mercante","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery IRCCS Humanitas Research Hospital Milan Italy"},{"name":"Department of Biomedical Sciences Humanitas University Milan Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0129-9908","authenticated-orcid":false,"given":"Apostolos","family":"Karligkiotis","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mario","family":"Bussi","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology Unit, Division of Head and Neck Department IRCCS San Raffaele Scientific Institute Milano Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cesare","family":"Piazza","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery, ASST Spedali Civili Brescia, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health University of Brescia Brescia Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1969-7760","authenticated-orcid":false,"given":"Alperen","family":"Vural","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Cerrahpasa Faculty of Medicine Istanbul University\u2014Cerrahpasa Istanbul Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5184-6140","authenticated-orcid":false,"given":"Paolo","family":"Castelnuovo","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, ASST Lariana Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Piero","family":"Nicolai","sequence":"additional","affiliation":[{"name":"Unit of Otorhinolaryngology\u2014Head and Neck Surgery Azienda Ospedale\u2010Universit\u00e0 Padova Padova Italy"},{"name":"Section of Otorhinolaryngology\u2014Head and Neck Surgery, Department of Neuroscience (DNS) University of Padova Padova Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maurizio","family":"Bignami","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, Ospedale di Circolo Varese Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1158-020X","authenticated-orcid":false,"given":"Christos","family":"Georgalas","sequence":"additional","affiliation":[{"name":"Medical School University of Nicosia Nicosia Cyprus"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Iacopo","family":"Dallan","sequence":"additional","affiliation":[{"name":"Skull Base and Rhino\u2010Orbital Surgery Unit Azienda Ospedaliero\u2010Universitaria Pisana Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Philippe","family":"Herman","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology and Skull Base Center, AP\u2010HP, Hospital Lariboisi\u00e8re Universit\u00e9 Paris Cit\u00e9 Paris France"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paolo","family":"Battaglia","sequence":"additional","affiliation":[{"name":"Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences University of Insubria, ASST Lariana Como Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,12,12]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0184477"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.04.016"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100138459"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1440-1606.1999.00242.x"},{"issue":"1","key":"e_1_2_10_6_1","first-page":"45","article-title":"Management of Oculo\u2010Orbital Complications of Odontogenic Sinusitis in Adults","volume":"68","author":"Preda M. 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