ABSTRACT

Objective: Complicated sinusitis is rare. It might not be identified early and might expose the patient to an unfavourable outcome. There is a paucity of data regarding this condition in the Caribbean. This study was undertaken to describe the clinical characteristics and treatment outcomes of patients admitted with this condition.

Methods: A retrospective chart review was performed on patients admitted to the University Hospital of the West Indies (UHWI) with complicated sinusitis between 1999 to 2011. The data were analysed using SPSS statistics 22 software.

Results: There were 30 patients (23 males and 7 females). The mean standard deviation (SD) age was 19 (13.96) years. Twenty-two had orbital complications, two had intracranial complications and one had both. The most common organisms isolated were streptococcus and the most common sensitivity was to amoxicillin and clavulinic acid. Sixteen patients who had an external surgical approach had a mean SD hospital stay of 8.8 (3.71) days compared to the three patients who had a purely endoscopic approach who had a mean SD hospital stay of 7.67 (0.577) days. There was no statistical difference in the mean hospital stay between these two groups (95% CI, -3.49, 5.78; p = 0.609). The mean duration of hospital stay for those treated medically was six days versus ten days for the surgical group. The mean difference was three days (95% CI, 0.193, 6.595; p = 0.039).

Conclusions: Acute complicated sinusitis is seen more commonly in adolescent males. The most common complication was orbital. Surgical treatment is indicated for those patients who fail medical management and should consist of an endoscopic approach which may be combined with open approaches if indicated.