Classification of Chandler et al for Orbital Complications of Acute Sinusitis

Description

Chandler et al described 5 groups of inflammatory or infectious complications associated with acute bacterial sinusitis. This is a modification of the scheme proposed by Smith and Spencer. The same pattern of reaction may be seen in other inflammatory processes involving the peri-orbital soft tissue.

Group	Descriptor	Features
I	inflammatory edema	fluid drainage impeded; marked edema of the eyelids with or without edema of the orbital contents; no tenderness is present
II	orbital cellulitis	diffuse edema, inflammation and bacteria without abscess formation
III	subperiosteal abscess
IV	orbital abscess	usually exophthalmos
V	cavernous sinus thrombosis	symptoms may appear in the opposite eye; prostration, meningismus and meningitis may be present

Group	Ocular Mobility	Visual Acuity
I	no limitation in ocular mobility	no impairment of visual acuity
II		variable impairment of visual acuity
III	no interference with ocular mobility during the early stages
IV	complete ophthalmoplegia present	usually severe visual impairment present
V	complete ophthalmoplegia present	usually severe visual impairment present

Other complications:

(1) intracranial abscess (extra-dural, intra-cerebral)

(2) bacterial meningitis

(3) osteomyelitis

To read more or access our algorithms and calculators, please log in or register.

Classification of Chandler et al for Orbital Complications of Acute Sinusitis

Description

Specialty