We thank Dr Burnstine for his comments. All our patients are seen and followed up by the pediatric ophthalmology service in conjunction with the pediatric otolaryngology service. Serial clinical examinations are performed. Frequently, the patient is admitted to the hospital with periorbital edema and erythema, and the computed tomographic scan is not obtained immediately but is performed only after the child has failed to respond to aggressive intravenous antimicrobial therapy and shows clinical signs of continued disease with fever, increased periorbital swelling, and progression of ophthalmologic signs. The decision for surgical intervention in our institutions is carried out with input from the pediatric ophthalmology service.
Froehlich P, Pransky SM. Minimal Endoscopic Approach—Reply. Arch Otolaryngol Head Neck Surg. 1998;124(6):711. doi:10.1001/archotol.124.6.711