THE GROOTE-SCHUUR-HOSPITAL CLASSIFICATION OF THE ORBITAL COMPLICATIONS OF SINUSITIS

The complications of sinusitis have been well described. The most comm on classifications used for orbital complications have been that of Ch andler et al. (1970) and Moloney et al. (1987). With the ready availab ility of high-resolution computed tomography (CT) scanners, limitation s of these classifications have become apparent. The aims of this stud y were to determine the relative frequency of the various complication s associated with acute sinusitis, to determine which groups of sinuse s were most frequently involved and to correlate the orbital signs wit h a new proposed classification of orbital complications. Over a five- year period, 87 consecutive patients were admitted with acute sinusiti s. Sixty-three patients (72.4 per cent) had one or more complications. When orbital complications were classified under the proposed classif ication, all patients with proptosis and/or decreased eye movement had post-septal infection. Visual impairment occurred only in the post-se ptal group. Most complications had a combination of sinus involvement with the maxillary/ethmoid/frontal combination being the most common. The authors propose a modification of Moloney's classification for orb ital complications of acute sinusitis that allows a clear differentiat ion between pre-and post-septal infection and a radiological different iation to be made between cellulitis/phlegmon and abscess formation. T he latter is of importance when a decision is made on whether surgical intervention is appropriate or not.