Computed tomographic patterns of orbital cellulitis due to sinusitis

Cruz, Antônio Augusto Velasco e; Anselmo-Lima, Wilma Teresinha; Júnior, Jorge Elias

doi:10.1590/s0004-27492006000400011

Cited by 32 publications

(21 citation statements)

References 36 publications

(40 reference statements)

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“…Orbital assessment with CT should be performed in patients who have physical examination findings suggestive of orbital cellulitis including limitation in eye movements, pain, reduction in visual acuity, proptosis, and ophthalmoplegia, whose ophthalmologic examination cannot be performed efficiently because of young age and who do not respond to parenteral antibiotic treatment. In addition, CT should also be performed when necessary because it shows the presence of complications including orbital abscess and subperiosteal abscess and accompanying sinusitis (21,22). Magnetic resonance (MR) is preferred for the assessment of soft tissues in terms of cavernous sinus thrombosis.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of patients with orbital infections

et al. 2018

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Aim: Orbital tissue infections are common infections of childhood that can lead to severe complications. Herein, we aimed to evaluate the etiologic factors, diagnosis, follow-up, and treatment procedures in pediatric patients with orbital infections. Material and Methods:This study was performed retrospectively between January 2014 and December 2015 in Cerrahpasa Medical Faculty Pediatric Infectious Disease Unit. Patients were studied for age, ophthalmologic examination features, laboratory and radiology results, treatment modalities, and the response to these treatments.Results: Thirty-six patients (21 males, 15 females) with an average age of 71.43±42.24 months (5-168 months) participated in the study in the two-year period. Thirty-two patients (88.9%) had preseptal cellulitis, and four (11.9%) had orbital cellulitis. All patients had eyelid hyperemia, edema, and ocular pain, with chemosis in seven and proptosis in four cases. Twenty-five patients were admitted with fever. All cases were unilateral and 44.4% occurred secondary to paranasal sinusitis. All cases were treated with intravenous cefazolin-amikacin. The mean of duration of hospitalization was 12.02±8.75 days (range, 3-28 days) and the duration of parental antibiotics was 12.83±8.18 days (range, 7-21 days). All patients recovered without any vision loss, only one patient experienced subdural empyema complicating preseptal cellulitis. Conclusions:Most orbital tissue infections occur secondary to paranasal sinusitis in childhood. Orbital tissue infections can be complicated by brain abscess, cavernous sinus thrombophlebitis, and vision loss. Early diagnosis and proper antibiotic treatment are essential to prevent these life-threatening complications.

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Section: Discussionmentioning

confidence: 99%

Evaluation of patients with orbital infections

et al. 2018

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“…Manyetik rezonans görüntüleme, kavernöz sinüs trombozu ve intrakraniyal apse gibi komplikasyonları değerlendirmede klinisyene yardımcı olan bir yöntemdir. 1,11 466 TJO 43; 6: 2013 Orbital selülit veya apselerin tedavisine intravenöz antibiyotik ile başlanır, 24-48 saat içerisinde düzelme görülmeyen ve progresyon gösteren olgularda cerrahi müdahale planlanır. 3 Orbital selülitli hastaya acil yaklaşımda intravenöz antibiyotik tedavisi veya cerrahi tedaviden hangisinin daha yararlı olduğu tartışmalıdır.…”

Section: Discussionunclassified

“…1 Olgular karşımıza farklı klinik tablolarla çıkabilmektedir. Orbita enfeksiyonlarının tarifinde çeşitli şemalar ve sınıflandırmalar kullanılmaktadır.…”

Section: Introductionunclassified

“…Orbita enfeksiyonlarının tarifinde çeşitli şemalar ve sınıflandırmalar kullanılmaktadır. 1 En sık kullanılan, 1970 yılında Chandler'in yapmış olduğu sınıflamada orbital enfeksiyonlar beş grupta incelenmektedir. Grup 1 preseptal selülit olup, göz kapağının intraorbital yapıları tutmadan oluşan ödemini; grup 2 orbital selülit olup, orbita içerisinde apse oluşmadan intraorbital diffüz ödem ve enflamasyon gelişmesini; grup 3 subperiostal apse olup, orbita kemik duvarı ile kemiği çevreleyen periost arasına apse mayinin toplanmasını; grup 4 orbital apse olup, orbita içerisinde iltihabi mayinin toplanmasını; grup 5 kavernöz sinüs trombozu olup, orbital enfeksiyonun geriye doğru yayılarak kavernöz sinüslere ulaşmasını tanımlamaktadır.…”

Section: Introductionunclassified

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Sinüzit Sonucu Gelişen Subperiostal Orbital Apse ve Frontal Epidural Apse: Olgu Sunumu

Ulaş¹,

Yaycıoğlu²,

Erkan³

et al. 2013

tjo

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ÖzetOn yedi yaşında bir kız hasta sol üst göz kapağında kızarıklık, şişlik ve ağrı ile kliniğimize başvurdu. Başka bir klinikte akut anjioödem ön tanısı ile 1 hafta yüksek doz oral steroid tedavisi alma öyküsü vardı. Hastanın oftalmolojik muayenesinde sol üst göz kapağının ödemli, şiş, hiperemik olduğu görüldü. Beraberinde sol gözde yukarı bakış kısıtlılığı mevcuttu. Düzeltilmiş en iyi görme keskinliği 0,7 idi. Hastanın bilgisayarlı tomografi incelemesinde etmoidal, maksiller ve frontal sinüzit, subperiostal orbital apse ve frontal epidural apse izlendi. İntravenöz antibiyotik tedavisi düzenlendi. Klinik bulguların devam etmesi üzerine cerrahi olarak apseler boşaltıldı. Hasta oral antibiyotik tedavisi ile taburcu edildi. Bir ay sonraki kontrolünde sol gözün yukarı bakış kısıtlılığının düzeldiği ve görme keskinliğinin 1,0'a yükseldiği görüldü. Göz kapaklarında şişlik ile gelen bir hastanın tedavisinde steroid kararı almadan önce ayırıcı tanının iyi yapılması gereklidir. Sinüzit sık görülen bir hastalık olup, orbital apse, epidural apse ve intrakranial komplikasyonlara yol açabileceği için akılda bulundurulmalıdır. (Turk J Ophthalmol 2013; 43: 464-7) Anahtar Kelimeler: Subperiostal orbital apse, orbital apse, epidural apse, sinüzit Sum maryA seventeen-year-old girl was admitted to our clinic with complaint of rubor, swelling, and pain on the left upper eyelid. Her medical history revealed that she had received high-dose oral steroid treatment for one week for the diagnosis of acute angioedema in another clinic. On ophthalmologic examination, her left upper eyelid had edema, swelling, and hyperemia. Additionally, she had restriction in up-gaze in the left eye. Her best-corrected visual acuity was 0.7. The patient's computerized tomography revealed ethmoidal, maxillary and frontal sinusitis, as well as subperiostal orbital abscess, and frontal epidural abscess. Intravenous antibiotic treatment has been arranged. Due to persistence of the clinical signs, surgical drainage of the abscesses has been performed. Following, she has been discharged from the hospital on oral antibiotic treatment. Postoperatively, at the first-month visit, the left eye's up-gaze restriction was recovered, and visual acuity was improved to 1.0. If a patient presents with eyelid swelling, differential diagnosis should be performed carefully before making the decision to start steroid treatment. Sinusitis, which is seen frequently in clinical practice, should be kept in mind due to its potential to cause orbital abscess, epidural abscess, and intracranial complications. (Turk J Ophthalmol 2013; 43: 464-7

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“…Orbital cellulitis can lead to dental abscess, trauma of orbit, peri-ocular surgery, panophthalmitis, septicaemia and immunosuppression but in the majority of the cases, they represent complications of maxillary sinusitis [1].…”

Section: Introductionmentioning

confidence: 99%

A Rare Case of Orbital Cellulitis Followed by Therapeutic(Orthodontic) Extraction

Prasad

Govardhan

2011

J. Maxillofac. Oral Surg.

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We report a rare case of orbital cellulitis occurring secondary to a dental infection followed by therapeutic (orthodontic) extraction. A 16 year old female patient presented to the dental office with a left orbital proptosis for the past 4 days. PNS view, CT scan revealed an abscess in relation to medial, lateral superior inferior walls of the orbit associated with naso ethmoidal and left maxillary sinus. Through nasal endoscopy, middle meatus antrostomy and ethmoidectomy was performed for the drainage of pus from the orbit, ethmoid and maxillary sinus under general anesthesia. Immediately regression of orbital swelling was noticed. Eyeball movements improved. Epiphora reduced and proptosis declined. With the advent of higher antibiotics, orbital infection rarely occurs secondary to dental causes except in a very few cases. Complete elimination of pus from orbital cavity, para nasal air sinuses and appropriate antibiotic coverage at the earliest forms the mainstay of treatment. The nasal endoscopic approach with orbital decompression is the most acceptable atrumatic, cosmetic and functional procedure.

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Computed tomographic patterns of orbital cellulitis due to sinusitis

Cited by 32 publications

References 36 publications

Evaluation of patients with orbital infections

Evaluation of patients with orbital infections

Sinüzit Sonucu Gelişen Subperiostal Orbital Apse ve Frontal Epidural Apse: Olgu Sunumu

A Rare Case of Orbital Cellulitis Followed by Therapeutic(Orthodontic) Extraction

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