A 6-year-old boy suffering from severe sinusitis with right sided orbital cellulitis prevented from losing eyesight.

About the Patient and Condition

Master Rudranjan Sinhababu, a 6-year-old boy was suffering from severe sinusitis with right sided orbital cellulitis. From the first week of December 2022, the child had fever along with cold and cough. With medication the fever subsided but there was progressively increasing swelling of eye, with pain, redness and restricted eye movements. He was previously treated in another hospital with IV antibiotics but no improvement and hence was further referred to Apollo Multispeciality Hospitals, Kolkata.

Case Scenario

Master Rudranjan was brought by his worried parents to Dr Shantanu Panja, Senior ENT – Head & Neck Surgeon at Apollo Multispeciality Hospitals, Kolkata on December 10, 2022. Upon receiving the patient, treatment was started immediately and investigations were carried out. CT Scan revealed that the child had extensive sinusitis with right sided orbital cellulitis. An urgent surgery was carried out by Dr Panja and his team on December 12, 2022. They carried out an Endoscopic Sinus Surgery with Orbital Decompression and evacuated the infective collection present inside the eye socket and sinuses. The entire surgery was carried without any external cut. It’s a scar-less procedure which was done endoscopically. At first the sinuses were entered endoscopically and infected materials were cleared. Next the bony wall separating the eyeball from the sinus cavity was removed and the covering of the orbit which is called the periorbita was exposed. The periorbita was cut and the content of the eyeball was explored. Pus and secretions from inside the eyeball was evacuated and thereby the entire orbit with the optic canal was decompressed.

As the pressure on the eye was relieved and pus was evacuated the child improved dramatically within 48 hours with resolution of swelling, improvement in vision and complete restoration of colour vision. Throughout the stay the child’s medical management was carried out under the care of Dr Kaushik Moulik, Consultant Paediatrics, Apollo Multispecialty Hospitals Kolkata and his team.

Worldwide Scenario

The incidence of orbital abscess in children with acute sinusitis is less than 1 per cent. It’s an extremely rare and serious condition which needs urgent surgery in experienced and expert hands to save the vision. Chronic sinusitis can be caused by an infection, growths in the sinuses (nasal polyps) or swelling of the lining of sinuses. Signs and symptoms may include a blocked or stuffy (congested) nose that causes difficulty breathing through the nose, and pain and swelling around eyes, cheeks, nose or forehead. Sinusitis is usually the result of a cold or flu virus spreading to the sinuses from the upper airways.

Expertise at Apollo Hospitals

Dr. Kaushik Maulik, Consultant Paediatrics, Apollo Multispeciality Hospitals Kolkata said, “The infection from the sinuses had spread to the eye with pus formation inside the eye socket. The child was very sick with restricted eyeball movements and diminishing vision. This is one of the dreaded complications of sinus infection where there is every chance that the child would lose his vision completely, unless timely intervention is carried out.”

As per Dr Shantanu Panja, Senior ENT-Head & Neck Surgeon at Apollo Multispeciality Hospitals, “The surgery was challenging as the child was only 6 years old. The surgery had to be carried out in a limited working space with absolute precision so that there was no damage to the eyeball and optic nerve. We even used ear microsurgery instruments for certain steps of the surgery as they are smaller in size and can be used with finesse in a smaller area.”

Apollo Hospitals – Touching Lives

Apollo Multispeciality Hospitals, Kolkata is equipped with the facility of the latest image guided navigation system which is often used for operating such critical cases. It helps doctors to locate the vital structures during surgery and prevent any damage to them.

Patient’s testimonial

The parents who hail from Durgapur were extremely relieved and happy that timely intervention and vigilant care saved the eyesight of their six-year-old son.