Advances in the Treatment of Orbital Cellulitis: Integrating Ophthalmology and Rhinology

• DOI: https://doi.org/10.22533/at.ed.1594562414068

• Palavras-chave: Post-septal cellulitis; Orbital cellulitis; Surgical treatment; Orbital abscess; Endoscopic sinus surgery.

• Keywords: Post-septal cellulitis; Orbital cellulitis; Surgical treatment; Orbital abscess; Endoscopic sinus surgery.

• Abstract: INTRODUCTION Post-septal cellulitis is an acute infection of the orbital tissues located posterior to the orbital septum, often arising from sinusitis but also associated with trauma, dental infections, and hematogenous spread. It presents a significant clinical challenge due to its potential for rapid progression and serious complications, including vision loss, abscess formation, and intracranial extension. Effective management requires prompt diagnosis, typically supported by imaging studies, and a clear understanding of the underlying etiologies and risk factors. Surgical intervention is indicated in cases refractory to medical management or when complications are imminent, and the evolution of surgical techniques, particularly the integration of endoscopic approaches, has significantly improved patient outcomes. OBJETIVE To evaluate the impact and effectiveness of surgical interventions in the treatment of post-septal cellulitis, focusing on patient outcomes, complication rates, and long-term recovery. METHODS This is a narrative review which included studies in the MEDLINE – PubMed (National Library of Medicine, National Institutes of Health), COCHRANE, EMBASE and Google Scholar databases, using as descriptors: “Post-septal cellulitis” AND “Orbital infections” AND “Surgical intervention” AND “Ophthalmology” AND “Otorhinology” in the last years. RESULTS AND DISCUSSION Surgical intervention for post-septal cellulitis has demonstrated significant efficacy in cases where medical management alone is insufficient. Early surgical intervention, particularly in the presence of abscesses or optic nerve involvement, is crucial for preventing permanent damage and improving overall outcomes. Studies have shown that endoscopic sinus surgery offers advantages over traditional approaches, including reduced morbidity and better visualization. The role of multidisciplinary teams, incorporating ophthalmologists and otorhinologists, has been emphasized in providing comprehensive care. Postoperative management, including careful monitoring and antibiotic therapy, is essential for preventing recurrence and managing complications. Patient factors such as age and comorbidities influence surgical outcomes, highlighting the need for individualized treatment plans. CONCLUSION The surgical management of post-septal cellulitis is a complex but essential aspect of treating this potentially serious condition. Advances in surgical techniques, particularly endoscopic methods, and a multidisciplinary approach have significantly improved patient outcomes. Early intervention, tailored to the individual patient's needs, can prevent severe complications and promote long-term recovery. Continued research and development in surgical practices, along with comprehensive postoperative care, are critical for optimizing the treatment of post-septal cellulitis.