{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:13:13Z","timestamp":1791969193136,"version":"4.3.4"},"reference-count":28,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2025,1,1]],"date-time":"2025-01-01T00:00:00Z","timestamp":1735689600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Otolaryngology - Head &amp; Neck Surgery"],"published-print":{"date-parts":[[2025,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To identify reliable clinical, biological, and radiological markers predicting the failure of medical treatment in pediatric patients with acute ethmoidal rhinosinusitis (AERS) and subperiosteal abscess, facilitating informed decisions regarding the need for surgical intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Retrospective multicenter cohort study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>Pediatric otorhinolaryngology departments at a tertiary-care center and a public hospital in France, spanning from January 2014 to January 2024.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Children under 18\u2009years diagnosed with Chandler stage III orbital complication of AERS, confirmed by computed tomography (CT).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Initial treatment with antibiotics, with surgical intervention as required based on clinical evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main Outcome Measures<\/jats:title>\n                    <jats:p>Factors associated with the need for surgical intervention, including demographic data, clinical examination, C-reactive protein (CRP) levels, leukocyte count, and CT evaluation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Out of 65 patients, 31 (48%) underwent surgery and 34 (52%) were treated with antibiotics alone. In multivariate analysis adjusted for age, the significant factors associated with surgical intervention included complete eyelid closure (odds ratio (OR)\u2009=\u20097.6;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), ophthalmoplegia (OR\u2009=\u200914.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), clinical exophthalmos (OR\u2009=\u200925.0;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001), CRP level &gt;60\u2009mg\/L (OR\u2009=\u20096.9;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.006), leukocyte count &gt;15,600\u2009g\/L (OR\u2009=\u20097.7;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.002), radiological exophthalmos (OR\u2009=\u20096.1;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.001), retro-septal cellulitis (OR\u2009=\u20093.5;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.02), posterior ethmoid opacification (OR\u2009=\u20096.1;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.03), and abscess width &gt;4\u2009mm (OR\u2009=\u20098.2;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009=\u2009.01).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions and Relevance<\/jats:title>\n                    <jats:p>Many patients can be managed medically. However, complete eyelid closure should prompt a CT scan. Exophthalmos, retro-septal cellulitis, or an abscess wider than 4\u2009mm is an indication for surgical drainage. Ophthalmoplegia should be interpreted in context. CRP level &gt;60\u2009mg\/L, a leukocyte count &gt;15,600\u2009g\/L, and posterior ethmoid opacification should lead to close monitoring. These findings can aid in developing a clinico-bio-radiological score to guide treatment decisions, potentially improving patient outcomes by standardizing care protocols.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19160216251349444","type":"journal-article","created":{"date-parts":[[2025,7,13]],"date-time":"2025-07-13T09:59:59Z","timestamp":1752400799000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Prognostic Factors of Pediatric Acute Ethmoidal Rhinosinusitis With Orbital Subperiosteal Abscess: A Retrospective Cohort Study"],"prefix":"10.1177","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2476-9554","authenticated-orcid":false,"given":"Eric","family":"Moreddu","sequence":"first","affiliation":[{"name":"Pediatric Otorhinolaryngology\u2014Head &amp; Neck Surgery, La Timone Children\u2019s Hospital, APHM, Aix-Marseille Univ, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie-Eva","family":"Rossi","sequence":"additional","affiliation":[{"name":"Pediatric Otorhinolaryngology\u2014Head &amp; Neck Surgery, La Timone Children\u2019s Hospital, APHM, Aix-Marseille Univ, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dalia","family":"Bellal","sequence":"additional","affiliation":[{"name":"Pediatric Otorhinolaryngology\u2014Head &amp; Neck Surgery, La Timone Children\u2019s Hospital, APHM, Aix-Marseille Univ, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fadi","family":"Alshawareb","sequence":"additional","affiliation":[{"name":"Otorhinolaryngology\u2014Head &amp; Neck Surgery, Avignon Hospital Center, Avignon, Provence-Alpes-C\u00f4te d\u2019Azu, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"Nicollas","sequence":"additional","affiliation":[{"name":"Pediatric Otorhinolaryngology\u2014Head &amp; Neck Surgery, La Timone Children\u2019s Hospital, APHM, Aix-Marseille Univ, Marseille, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jawad","family":"Qarbal","sequence":"additional","affiliation":[{"name":"Pediatric Otorhinolaryngology\u2014Head &amp; Neck Surgery, La Timone Children\u2019s Hospital, APHM, Aix-Marseille Univ, Marseille, France"},{"name":"Otorhinolaryngology\u2014Head &amp; Neck Surgery, Avignon Hospital Center, Avignon, Provence-Alpes-C\u00f4te d\u2019Azu, France"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,7,13]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/alr.22535"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-018-4897-4"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-035206"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2017.02.031"},{"issue":"4","key":"e_1_3_2_6_2","first-page":"64","article-title":"Rhinosinusogenic orbital complications: the prevalence and principles of treatment","volume":"2010","author":"Giusan AO","year":"2010","unstructured":"Giusan AO, Kubanova AA, Uzdenova RK. 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