{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T11:08:12Z","timestamp":1788260892177,"version":"build-2803163510"},"reference-count":24,"publisher":"American Academy of Pediatrics (AAP)","issue":"9","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:sec>\n                    <jats:title>OBJECTIVE<\/jats:title>\n                    <jats:p>Little is known about the use of intranasal agents in the management of orbital infections in children. This study aims to describe intranasal corticosteroid use in children hospitalized with orbital infections and to determine whether an association exists between intranasal corticosteroids and length of hospital stay.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>A multicenter retrospective cohort study was conducted of children aged 2\u00a0months to 18 years with orbital infections, periorbital and orbital cellulitis, admitted to participating hospitals between 2009 and 2018. Baseline characteristics and intranasal corticosteroid use were described. The association between intranasal corticosteroids and length of stay was derived using a multivariable median regression model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>Of the 1570 children (935 [59.6%] male, median age 5.4 [IQR 2.4, 9.9] years) admitted for orbital infections, 693 (44.1%) received intranasal corticosteroids during their hospital admission. Median length of stay was 82.6 hours (IQR 48.3, 135.0). Of those who received intranasal corticosteroids, most received mometasone (n\u2009=\u2009497, 71.7%). In the adjusted analyses, children who received intranasal corticosteroids had longer hospital stay by 14.9 hours (95% CI 8.4\u201321.4) as compared with those without intranasal corticosteroids. Findings were similar when the analysis was restricted to children with a diagnosis of orbital cellulitis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>CONCLUSION<\/jats:title>\n                    <jats:p>Intranasal corticosteroid use in hospitalized children with periorbital and orbital cellulitis was associated with a small increase in length of stay, although immortal time bias or confounding by indications may be the primary driver of this given our study design. Further investigation is needed to better determine the effectiveness of intranasal corticosteroid use in children with orbital infections.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1542\/hpeds.2025-008935","type":"journal-article","created":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T00:03:08Z","timestamp":1786320188000},"page":"751-757","source":"Crossref","is-referenced-by-count":1,"title":["The Association Between Intranasal Steroids and Length of Stay in Children With Orbital Infections"],"prefix":"10.1542","volume":"16","author":[{"given":"Winnie W.","family":"Yu","sequence":"first","affiliation":[{"name":"1Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia M.","family":"Borkhoff","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"3Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"4Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaus E.","family":"Wolter","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"5Department of Otolaryngology, Head & Neck Surgery, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sanjay","family":"Mahant","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"3Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"4Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada"},{"name":"6Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Olivier","family":"Drouin","sequence":"additional","affiliation":[{"name":"7Department of Pediatrics, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"8Division of General Pediatrics, Department of Pediatrics, CHU Sainte-Justine, Montr\u00e9al, Qu\u00e9bec, Canada"},{"name":"9Department of Social and Preventive Medicine, School of Public Health, Universit\u00e9 de Montr\u00e9al, Montr\u00e9al, Qu\u00e9bec, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catherine","family":"Pound","sequence":"additional","affiliation":[{"name":"10Department of Pediatrics, University of Ottawa, Children\u2019s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Quet","sequence":"additional","affiliation":[{"name":"10Department of Pediatrics, University of Ottawa, Children\u2019s Hospital of Eastern Ontario (CHEO), Ottawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gita","family":"Wahi","sequence":"additional","affiliation":[{"name":"11Department of Pediatrics, McMaster University, Hamilton, Ontario, Canada"},{"name":"12McMaster Children\u2019s Hospital, Hamilton, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ann","family":"Bayliss","sequence":"additional","affiliation":[{"name":"13Trillium Health Partners, Department of Paediatrics, University of Toronto, Mississauga, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gemma","family":"Vomiero","sequence":"additional","affiliation":[{"name":"14Department of Pediatrics, University of Calgary, Alberta Children\u2019s Hospital, Calgary, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica L.","family":"Foulds","sequence":"additional","affiliation":[{"name":"15Department of Pediatrics, University of Alberta, Stollery Children\u2019s Hospital, Edmonton, Alberta, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronik","family":"Kanani","sequence":"additional","affiliation":[{"name":"16North York General Hospital, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahmoud","family":"Sakran","sequence":"additional","affiliation":[{"name":"17Department of Paediatrics, Queens University, Lakeridge Health, Oshawa, Ontario, Canada"},{"name":"18Research, Lakeridge Health, Oshawa, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anupam","family":"Sehgal","sequence":"additional","affiliation":[{"name":"19Kingston Health Sciences Centre, Queens University, Kingston, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eleanor","family":"Pullenayegum","sequence":"additional","affiliation":[{"name":"4Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada"},{"name":"20Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elysa","family":"Widjaja","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"3Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arun","family":"Reginald","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"21Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patricia C.","family":"Parkin","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"3Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"4Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, Canada"},{"name":"6Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter J.","family":"Gill","sequence":"additional","affiliation":[{"name":"2The Hospital for Sick Children, Toronto, Ontario, Canada"},{"name":"3Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada"},{"name":"4Child Health Evaluative Sciences, SickKids Research Institute, Toronto, Ontario, 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