Avtor/Urednik		Podboj, Jernej
Naslov		Endoskopska kirurgija pri orbitalnih zapletih sinusitisov
Prevedeni naslov		Endoscopic surgery for orbital complications of sinusitis
Tip		članek
Vir		Endoskopska Revija
Vol. in št.		Letnik 4, št. 8
Leto izdaje		1999
Obseg		str. 5-9
Jezik		slo
Abstrakt		Background. Sinusitis only rarely spreads to adjacent structures, but when it does, it produces mostly orbital complications. The characteristics of orbital complications of sinusitis depend on the anatomy of orbital structures. According to Chandler's classification orbital complications fall into five groups. Patients with suspected orbital involvement should be placed on intensive drug therapy, which mostly proves effective if started in early stages of the disease. Emergency surgery is indicated in patients who fail to respond to conservative treatment shortly after its institution. Patients and results. During the period 1988-1997, 61 patients aged 1 to 51 years (mean age 6.8 yrs) were treated for orbital complications of sinusitis at the Department of Otorhinolaryngology and Cervicofacial Surgery. University Medical Centre Ljubljana. In 95% of the patients complications occurred as a results of acute sinusitis, while in 5% they followed an exacerbation of chronic sinusitis. Conservative therapy proved successful in 51 patients, while 10 patients needed endoscopic surgery. There were no intra- or postopeative complications. Conclusions. In the management of orbital complications of sinusitis, classical operations should be replaced by less invasive and more accurate endoscopic procedures, which afford better visualization and drainage, and allow for simultaneous correction of anatomic abnormalities of the nasal cavities. The disadvantage of endoscopy is that it is technically demanding because of increased bleeding and oedema due to acute inflammation of the mucous membrane.
Izvleček		Izhodišča. Vnetje obnosnih votlin se le redko razširi v okolico, pri tem so največkrat prizadeta tkiva v orbiti. Značilnosti orbitalnih zapletov sinusitisa so odvisne od anatomskih posebnosti vsebine orbite in od bližine obnosnih votlin. Po Chandlerju razvrstimo orbitalne zaplete v pet stopenj. Kadar s konzervativnim zdravljenjem v kratkem času ne dosežemo izboljšanja, je na mestu urgentni kirurški poseg. Bolniki in rezultati. Na Kliniki za otorinolaringologijo in cervikofacialno kirurgijo v Ljubljani smo od leta 1988 do 1997 obravnavali 61 bolnikov z orbitalnimi zapleti sinusitisa, starih od enega leta do 51 let (povrečna starost 6,8 let). Zaplet je bil pri 95% bolnikov posledica akutnega sinusitisa in le pri 5% bolnikov posledica akutne ponovitve kroničnega sinusitisa. Konzervativno zdravljenje je bilo uspešno pri 51 bolnikih, 10 bolnikov pa smo endoskopsko operirali. Pri operacijah in v poperativnem obdobju ni bilo zapletov. Zaključki. Pri operativnem zdravljenju orbitalnih zapletih sinusitisov bi morali klasične kirurške posege nadomestiti z manj invazivnimi, ohranitvenimi endoskopskimi posegi, ki poleg boljšega pregleda prizadetega področja omogočajo tudi boljšo drenažo, hkrati pa tudi odpravo anatomskih anomalij v nosnih votlinah. Relativna slabost endoskopskih posegov je v težavnosti operiranja zaradi izrazite otekline vnete sluznice in obilnejše krvavitve.
Deskriptorji		SINUSITIS ORBITAL DISEASES SURGERY, ENDOSCOPIC SLOVENIA OPHTHALMOLOGY ENDOSCOPY INFLAMMATION ABSCESS