Nose and paranasal sinuses: Chandler staging of orbital infection: practice question

A ENT question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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ENT · Nose and paranasal sinuses: Chandler staging of orbital infection

Sample item

A child with ethmoid sinusitis has proptosis with the globe displaced down and laterally, painful restricted eye movements and preserved vision. CT shows a lentiform collection along the medial orbital wall. According to Chandler classification, which stage is this?

AGroup IV, orbital abscessBGroup II, orbital cellulitisCGroup V, cavernous sinus thrombosisDGroup III, subperiosteal abscess

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Group III, subperiosteal abscess

Chandler groups: I preseptal cellulitis, II orbital cellulitis, III subperiosteal abscess, IV orbital abscess, V cavernous sinus thrombosis. A collection between the lamina papyracea periosteum and the orbital contents displaces the globe away from the abscess, here down and laterally. Treatment is intravenous antibiotics and drainage when indicated.

Option by option

A. Group IV, orbital abscess
Group IV is a collection within the orbital fat, with marked visual loss and ophthalmoplegia.
B. Group II, orbital cellulitis
Group II is diffuse orbital inflammation without a collection.
C. Group V, cavernous sinus thrombosis
Group V involves bilateral signs and systemic toxicity from cavernous sinus thrombosis.
D. Group III, subperiosteal abscess (correct)
Correct. A discrete collection under the periosteum of the orbital wall is group III.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

Questions about this ENT question

What is the answer to this ENT question?

The best answer is D, Group III, subperiosteal abscess. Chandler groups: I preseptal cellulitis, II orbital cellulitis, III subperiosteal abscess, IV orbital abscess, V cavernous sinus thrombosis.

Why is "Group IV, orbital abscess" not the answer?

Group IV is a collection within the orbital fat, with marked visual loss and ophthalmoplegia.

Why is "Group II, orbital cellulitis" not the answer?

Group II is diffuse orbital inflammation without a collection.

Why is "Group V, cavernous sinus thrombosis" not the answer?

Group V involves bilateral signs and systemic toxicity from cavernous sinus thrombosis.

What concept does this question test?

It tests Nose and paranasal sinuses: Chandler staging of orbital infection in ENT. A collection between the lamina papyracea periosteum and the orbital contents displaces the globe away from the abscess, here down and laterally. Treatment is intravenous antibiotics and drainage when indicated.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Nose and paranasal sinuses: Chandler staging of orbital infection?

Learn tuning fork results and audiogram patterns by sketching them. Then use the flashcards and the other ENT questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.