Management of Orbital Subperiosteal Abscess in Children

Abstract

Bilateral pansinusitis was the most common cause. All patients received an initial trial of intravenous antibiotics. Based on the Fisher exact test, no statistically significant differences were detected for age, sex, presence of gaze restriction, and radiographic findings. Based on multiple logistic regression, degree of proptosis was the only significant multivariate predictor of surgery (P =.003). The estimated probability of surgery was 6% when there was no proptosis, and 92% for 2 mm of proptosis. The location of the SPA determined the route of surgical drainage. Eleven patients with a medially based SPA underwent drainage via the transnasal endoscopic approach, and 3 with a superior SPA underwent drainage externally. The external approach was associated with a longer hospital stay (median, 7 days) than either the endoscopic or the intravenous antibiotic approach (median, 5 days).

Transorbital Neuroendoscopic Management of Sinogenic Complications Involving the Frontal Sinus, Orbit, and Anterior Cranial Fossa

“…[2][3][4] In the past decade, endonasal techniques replaced the traditional external surgical approaches to manage the majority of these complications. 5,6 Indeed, endoscopic sinus surgery (ESS) has provided effective and safe options for managing sinogenic complications of the orbit, frontal sinus, and anterior skull base that would previously have necessitated extensive open approaches. [7][8][9][10][11] However, certain regions involved in pathology of the sinuses either cannot be accessed in this fashion or they endanger critical neurovascular structures when transnasal pathways are employed.…”

Left subperiosteal abscess with contralateral preseptal cellulitis: A case report

“…Nowadays, despite antimicrobial and surgical management, 15% to 30% of patients with an SPA develop various visual sequelae. [3] Overtime, the number of orbital complications has reduced, however, the orbital complications of acute rhinosinusitis are still dreaded.…”

Surgical Management of Subperiosteal Orbital Abscess: Case Report

“…Previously, it has been reported that there is no significant difference in the failure rates of transnasal endoscopic, external or combined approaches. 5,14 In our clinic, we applied medical treatment with a combination of ampicillin and beta lactamase inhibitors with metronidazole, and performed surgical intervention when a subperiosteal developed and was resistant to medical treatment. 15,16 We performed functional sinus surgery combined with external orbitotomy in two cases of whom the CT scans showed ethmoiditis whereas in one case, external orbitotomy was performed alone as it was superiorly located and endoscopically unapproachable.…”