Robin A Crosbie1, Jonathan Nairn2, Haytham Kubba3. 1. Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland. Electronic address: crosbie.robin@gmail.com. 2. University of Dundee Medical School, Dundee, Scotland. 3. Department of Otolaryngology, Royal Hospital for Children, Glasgow, Scotland.
Abstract
INTRODUCTION: Paediatric periorbital cellulitis is a common condition. Accurate assessment can be challenging and appropriate use of CT imaging is essential. We audited admissions to our unit over a four year period, with reference to CT scanning and adherence to our protocol. METHODS: Retrospective audit of paediatric patients admitted with periorbital cellulitis, 2012-2015. RESULTS: Total of 243 patients included, mean age 4.7 years with slight male predominance, the median length of admission was 2 days. 48/243 (20%) underwent CT during admission, 25 (52%) of these underwent surgical drainage. As per protocol, CT brain performed with all orbital scans; no positive intracranial findings on any initial scan. Three children developed intracranial complications subsequently; all treated with antibiotics. Our re-admission rate within 30 days was 2.5%. CONCLUSIONS: Our audit demonstrates benefit of standardising practice and the low CT rate, with high percentage taken to theatre and no missed abscesses, supports the protocol. There may be an argument to avoid CT brain routinely in all initial imaging sequences in those children without neurological signs or symptoms.
INTRODUCTION: Paediatric periorbital cellulitis is a common condition. Accurate assessment can be challenging and appropriate use of CT imaging is essential. We audited admissions to our unit over a four year period, with reference to CT scanning and adherence to our protocol. METHODS: Retrospective audit of paediatric patients admitted with periorbital cellulitis, 2012-2015. RESULTS: Total of 243 patients included, mean age 4.7 years with slight male predominance, the median length of admission was 2 days. 48/243 (20%) underwent CT during admission, 25 (52%) of these underwent surgical drainage. As per protocol, CT brain performed with all orbital scans; no positive intracranial findings on any initial scan. Three children developed intracranial complications subsequently; all treated with antibiotics. Our re-admission rate within 30 days was 2.5%. CONCLUSIONS: Our audit demonstrates benefit of standardising practice and the low CT rate, with high percentage taken to theatre and no missed abscesses, supports the protocol. There may be an argument to avoid CT brain routinely in all initial imaging sequences in those children without neurological signs or symptoms.
Authors: Mohamad Z Saltagi; Cyrus C Rabbani; Kunal S Patel; Todd J Wannemuehler; Rao V Chundury; Elisa A Illing; Jonathan Y Ting Journal: Allergy Rhinol (Providence) Date: 2022-04-27