{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T09:13:14Z","timestamp":1791969194078,"version":"4.3.4"},"reference-count":41,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2022,1,1]],"date-time":"2022-01-01T00:00:00Z","timestamp":1640995200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Allergy\ufffdRhinol (Providence)"],"published-print":{"date-parts":[[2022,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Surgery is often avoided in the setting of pediatric orbital complications from acute sinusitis unless necessitated by alarming ophthalmological signs. Criteria for surgical intervention are not well-defined.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>We aim to review our experiences, management practices and patient outcomes over a ten-year period for Chandler III patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective review was performed from January 1, 2007 through December 31, 2016 of patients treated for orbital symptoms secondary to acute sinusitis at a free-standing tertiary-care pediatric hospital.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of the 186 patients reviewed, 42 Chandler III patients were included. Average age was 82.6 months (SD 50.6) with a slight male predominance (M to F, 1.8 to 1). 27 patients (64.3%) underwent intervention including endoscopic sinus surgery (ESS) with or without orbitotomy. Late surgical intervention (&gt;48hrs from admission) demonstrated significant increase in overall length of stay (LOS) when compared with early surgical intervention and\/or medical management (median, 6.9 vs 3.6 vs 3.7 days; p\u2009&lt;\u20090.01). Postoperative LOS was also higher in the late surgery group compared with patients who had surgery within 48 hours of admission, but this did not reach statistical significance [median, 3.8 vs 2.8 days, p=\u20090.12]. There was no significant difference in overall abscess volume between patients who underwent intervention and those who did not (1019 mm\n                      <jats:sup>3<\/jats:sup>\n                      vs 805 mm\n                      <jats:sup>3<\/jats:sup>\n                      , p\u2009=\u20090.5), but abscess width\u2009\u2265\u20091.2 cm was associated with higher rates of intervention. An alarming extraocular exam was the most common factor associated with surgical intervention.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Pediatric subperiosteal orbital abscess may prompt surgical intervention by ESS. An alarming ophthalmologic exam should prompt consideration of early intervention, which may lead to decreased overall and post-operative length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>4<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Meeting Information<\/jats:title>\n                    <jats:p>American Rhinologic Society, Fall National Meeting. Chicago, IL, USA. September 8\u20139, 2017.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/21526575221097311","type":"journal-article","created":{"date-parts":[[2022,4,27]],"date-time":"2022-04-27T04:03:38Z","timestamp":1651032218000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":29,"title":["Orbital Complications of Acute Sinusitis in Pediatric Patients: Management of Chandler III Patients"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0410-3010","authenticated-orcid":false,"given":"Mohamad Z.","family":"Saltagi","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Indianapolis, IN, USA"},{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cyrus C.","family":"Rabbani","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Indianapolis, IN, USA"},{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kunal S.","family":"Patel","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"},{"name":"Department of Ophthalmology, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Todd J.","family":"Wannemuehler","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Indianapolis, IN, USA"},{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rao V.","family":"Chundury","sequence":"additional","affiliation":[{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"},{"name":"Department of Ophthalmology, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8497-7876","authenticated-orcid":false,"given":"Elisa A.","family":"Illing","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Indianapolis, IN, USA"},{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jonathan Y.","family":"Ting","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery, Indianapolis, IN, USA"},{"name":"Indiana University School of Medicine, Indianapolis, IN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,4,27]]},"reference":[{"key":"bibr1-21526575221097311","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2018.05.006"},{"key":"bibr2-21526575221097311","doi-asserted-by":"publisher","DOI":"10.1016\/S0891-5520(20)30492-X"},{"key":"bibr3-21526575221097311","unstructured":"Connell B, Kamal Z, McNab AA. 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