The role of adjuvant systemic steroids in the management of periorbital cellulitis secondary to sinusitis: a systematic
- PDF / 702,243 Bytes
- 9 Pages / 595.276 x 790.866 pts Page_size
- 82 Downloads / 189 Views
REVIEW ARTICLE
The role of adjuvant systemic steroids in the management of periorbital cellulitis secondary to sinusitis: a systematic review and meta‑analysis Sridhayan Mahalingam1 · Louis Luke2 · Jyotsna Pundir3 · Vishal Pundir4 Received: 2 July 2020 / Accepted: 13 August 2020 © Springer-Verlag GmbH Germany, part of Springer Nature 2020
Abstract Purpose The role of adjuvant systemic corticosteroids in the management of periorbital cellulitis and subperiosteal/orbital abscesses secondary to sinonasal infections is not well understood. Our objective was to systematically review the current evidence on the efficacy and side effects of systemic steroids when used in the management of periorbital cellulitis. Methodology A systematic review of literature was conducted in accordance with PRISMA guidance. A systematic search of MEDLINE, Embase and Cochrane databases, MetaRegister and ISI conference proceedings was conducted. The outcomes of interest were duration of inpatient stay, requirement for surgical intervention, adverse effects and recurrent/residual symptoms. Results Four studies were identified involving 118 patients. Of these, 78 underwent treatment with systemic corticosteroids and 40 were controls. Meta-analysis demonstrated that the mean duration of inpatient stay was significantly shorter in the steroid group (WMD − 2.90 days; 95% CI − 3.07, − 2.73; p 50% was taken as evidence of substantial heterogeneity and in such cases a random effect model was used. A Chi-squared test for heterogeneity was also performed and p values presented. When a study did not present a standard deviation (SD) or mean, this was calculated from raw data available, and when this was not possible, relevant authors were contacted to seek clarification [4, 12]. As previously described, statistical analyses were performed using RevMan 5 software [7].
cohort studies and one retrospective cohort study (Table 1) [4, 12–14]. Blinding for outcomes was in place in only one study [13]. A risk of bias graph could not be generated because of the different characteristics of the studies involved.
Study population
107 studies were retrieved, of which four studies investigating systemic steroid use in the inpatient management of periorbital cellulitis were identified (Fig. 1).
Yen et al. and Chen et al. exclusively reviewed children who had developed SPAs secondary to sinusitis [4, 14]. Davies et al. reviewed children aged 1–18 years who all had SPAs [12]. Although the majority appeared secondary to sinusitis, the exact proportion is unknown. The authors could not provide us with any further information; hence all patients were included in the analysis. Pushker et al. included patients with orbital cellulitis, SPAs, orbital abscesses and excluded children
Data Loading...
