Rhinosinusitis Kronik Eksaserbasi Akut dengan Komplikasi Chandler II

Teuku Husni T R; Mhd Nurul Imam Saragih

doi:10.35324/jknamed.v9i1.390

Teuku Husni T R Bagian Ilmu Kesehatan Telinga Hidung Tenggorok Bedah Kepala dan Leher, Fakultas Kedokteran Universitas Syiah Kuala, RSUD Dr. Zainoel Abidin
Mhd Nurul Imam Saragih Departemen Ilmu Kesehatan Telinga Hidung Tenggorok- Bedah Kepala Leher, Fakultas Kedokteran Universitas Syiah Kuala, Banda Aceh

DOI: https://doi.org/10.35324/jknamed.v9i1.390

Keywords: Rhinosinusitis kronik, Komplikasi orbita, Chandler II.

Abstract

Latar belakang: Rhinosinusitis kronik (CRS) umumnya bersifat self-limiting, namun dapat berkembang menjadi komplikasi serius seperti komplikasi orbita. Chandler II (orbital selulitis) terjadi akibat penyebaran infeksi ke jaringan orbital postseptal dan berisiko menyebabkan gangguan penglihatan. Tujuan: Melaporkan kasus CRS dengan komplikasi Chandler II serta meninjau diagnosis dan tatalaksananya. Kasus: Pria 45 tahun dengan hidung tersumbat, sekret purulen, nyeri wajah, demam, dan pembengkakan mata kiri. CT scan menunjukkan lesi orbita kiri, proptosis, erosi lamina papiracea, dan sinusitis multipel sesuai Chandler II. Pasien menjalani FESS dan menunjukkan perbaikan klinis pascaoperasi. Metode: Tinjauan literatur melalui PubMed dan sumber ilmiah lain dengan seleksi berdasarkan kriteria inklusi dan eksklusi. Hasil: Komplikasi orbita terjadi akibat penyebaran infeksi sinus dengan diagnosis klinis dan pencitraan. Tatalaksana meliputi antibiotik intravena dan intervensi bedah sesuai derajat keparahan. Kesimpulan: Chandler II memerlukan diagnosis dini dan terapi adekuat berupa antibiotik serta FESS dengan prognosis yang baik bila ditangani tepat.

Background: Chronic rhinosinusitis (CRS) is generally self-limiting but may progress to serious complications such as orbital involvement. Chandler II (orbital cellulitis) results from the spread of infection into the postseptal orbital tissues and carries a risk of visual impairment. Purpose: To report a case of CRS with Chandler II complication and review its diagnosis and management. Case: A 45-year-old male presented with nasal obstruction, purulent nasal discharge, facial pain, fever, and left eye swelling. CT scan revealed a left orbital lesion, proptosis, lamina papyracea erosion, and multiple sinusitis consistent with Chandler II. The patient underwent FESS and showed clinical improvement postoperatively. Method: A literature review was conducted using PubMed and other scientific sources with selection based on inclusion and exclusion criteria. Results: Orbital complications arise from the spread of sinus infection, with diagnosis based on clinical findings and imaging. Management includes intravenous antibiotics and surgical intervention according to severity. Conclusion: Chandler II requires early diagnosis and appropriate treatment with antibiotics and FESS, resulting in a good prognosis when managed properly.