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Orbital infections: a complete cycle 7-year audit and a management guideline

  • Head & Neck
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objectives

Orbital infections are regularly encountered and are managed by various healthcare disciplines. Sepsis of the orbit and adjacent tissues can be associated with considerable acute complication and long-term sequelae. Therefore, prompt recognition and management of this condition are crucial. This article presents the outcomes of a 7-year complete cycle audit project and describes the development of the new local guideline on the management of orbital infections in our tertiary centre.

Methods

(1) A retrospective 5-year audit cycle on patients with orbital infections. (2) A review of available evidence on the management of orbital infections. (3) A new local multidisciplinary guideline on the management of orbital infections. (4) A retrospective 2-year second audit cycle to assess the clinical outcomes.

Results

Various disciplines intersect in the management of orbital infections. Standardising the management of this condition proved to be achievable through the developed guideline. However, room for improvement in practice exists in areas such as the promptness in referring patients to specialist care, the multidisciplinary assessment of patients on admission, and the improvement of scanning requests of patients.

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Authors and Affiliations

  1. ENT Department, University Hospitals Plymouth NHS Trust, Peninsula Schools of Medicine and Dentistry, Plymouth University, Plymouth, UK

    Mihiar Sami Atfeh & Hisham Saleh Khalil

  2. Department of Critical Care, King’s College Hospital, Denmark Hill, London, SE5 9RS, UK

    Kathryn Singh

Authors
  1. Mihiar Sami Atfeh
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  2. Kathryn Singh
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  3. Hisham Saleh Khalil
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Corresponding author

Correspondence to Kathryn Singh.

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Conflict of interest

All authors declare that they have no conflict of interest.

Ethical considerations

The formal local ethical procedures were followed and patients’ data were anonymised throughout the project. A formal application to the local clinical audit department was submitted and approved prior to initiating the project data collection. Regular feedback to the clinical audit department was provided throughout the progress of the project. The clinical guideline was formally approved by the Medical Director, Assistant Medical Director, and was reviewed by the Patient Safety team and the Quality facilitators. No patient-identifying data were retained during data collection. The first and third authors are the developers of the clinical guideline and permit the use of the guideline for the purposes of publication. During the development of the clinical guideline, multiple “versions” were produced gradually until the approval of a final version which was published as “version 1” on the Trust’s guidelines portal. The guideline “version 1” was reviewed in 2017 and remained unchanged and, therefore, remains named as “version 1”.

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Atfeh, M.S., Singh, K. & Khalil, H.S. Orbital infections: a complete cycle 7-year audit and a management guideline. Eur Arch Otorhinolaryngol 275, 2079–2088 (2018). https://doi.org/10.1007/s00405-018-5025-1

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  • DOI: https://doi.org/10.1007/s00405-018-5025-1

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