Odontogenic Abscess With Orbital Extension Through the Inferior Orbital Fissure Treated With Bony Decompression

Rothschild, Michael; Pinheiro‐Neto, Carlos D.; Rubinstein, Tal J.

doi:10.1097/iop.0000000000001655

Cited by 4 publications

(3 citation statements)

References 14 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Less frequently, frontal or maxillary sinusitis can generate orbital septic complications by spreading the infection through the floor, respectively the orbital ceiling. Another mechanism described by Rothschild et al (7) is that the infection spreads through the maxillary sinus, the canine fossa with a thrombophlebitis of the angular vein or the pterygopalatine fossa and infra-temporal fossa both reaching the orbit by means of the inferior orbital fissure. The involved flora is mixed, consisting of aerobes and anaerobes, and the diversity of flora and the presence of anaerobes in maxillary sinusitis increase with age (1,8).…”

Section: Discussionmentioning

confidence: 99%

“…Therapeutic management should be initiated urgently when orbital cellulitis is suspected, due to the formidable complications, such as acute vision loss, cavernous sinus thrombosis, or septic intracranial dissemination (7)(8)(9)(10)(11)(12)(13)(14)(15). High-dose intrave-nous antibiotic therapy will be initiated with broad-spectrum, Gram-positive, Gram-negative, and anaerobic antibiotic combinations.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Odontogenic orbital cellulitis. Case report and review of literature

Daniela

2021

MSJ

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Odontogenic orbital cellulitis. Case report and review of literature

Daniela

2021

MSJ

View full text Add to dashboard Cite

“…Odontogenic infections usually gain access to the orbit through the maxillary sinus and associated facial vasculature. However, these infections may gain access posteriorly, as seen in a case report by Rothschild et al, where the odontogenic infection spread to the deep temporal space, pterygopalatine fossa, and into the orbit through the inferior orbital fissure [ 43 ].…”

Section: Introductionmentioning

confidence: 99%

Complications of Severe Odontogenic Infections: A Review

Neal

Schlieve

2022

Biology

View full text Add to dashboard Cite

Severe odontogenic infections are routinely treated with little associated morbidity and mortality. Improvements in surgical techniques, antibiotic treatments, and imaging modalities have made associated complications exceedingly rare. A number of complications have been described in the literature including airway obstruction, descending necrotizing mediastinitis, orbital abscess, septic cavernous sinus thrombosis, cerebral abscess, sepsis, necrotizing fasciitis, and Lemierre’s syndrome. The purpose of this article is to discuss the pathophysiology of severe odontogenic infections and the risk factors associated with the development of complications. Given the morbidity and mortality of these conditions, it is important to review the clinical features of each and the diagnostic tools that aid in early recognition.

show abstract

Odontogenic orbital cellulitis: literature review

Guichaoua,

Genest-Beucher,

Boisrame

2024

J Oral Med Oral Surg

View full text Add to dashboard Cite

Introduction: Odontogenic origin is a rare cause (1.3–5%) of cases of orbital cellulitis, but it can lead to very important morbidity such as blindness or thrombosis of the cavernous sinus. It is therefore important to know how to recognize it. Methods: A literature review was performed. The parameters analyzed included age, sex, ethnicity, clinical presentation, imaging to determine orbital involvement, etiology, microbiology, treatment (medical and/or surgical), and final outcome of each case. Chandler's classification was used to classify the different types of cellulitis. Results: Thirty-five cases of odontogenic orbital cellulitis have been described in literature from 1980 to 2022. In 42.9% of cases, the cellulitis corresponded to an intra-orbital abscess (Chandler stage IV). Thrombosis of the cavernous sinus (stage V) was detected in 5.7% of cases. Periorbital edema (100%), ocular or facial pain (82.9%) and limitation of eye movements (82.9%) were the three most common ophthalmological signs. The anamnesis revealed an element pointing to a dental origin in 97.1% of the cases, the two most frequent being a dental avulsion (20%) or an endodontic treatment (14.3%), in days or weeks preceding the onset of symptoms. Imaging was performed on admission in 94.3% of cases. Regarding the most frequently encountered germs, commensal streptococcus of the oral cavity or anaerobic bacteria were found in 25.7% of cases, and coagulase-negative staphylococcus in 22.9% of cases. In 94.3% of cases, broad-spectrum intravenous antibiotic therapy was initiated as soon as the diagnosis was made. The common feature was the use of metronidazole in 51.4% of cases, combined with a third-generation cephalosporin (11.4%) or amoxicillin-clavulanic acid (8.6%). Orbital drainage was necessary in 71.4% of cases to allow resolution of symptoms, associated with drainage of the maxillary sinus in 45.7% of cases. Finally, the treatment allowed a recovery without sequelae in 80% of cases. Discussion: In case of suspected orbital cellulitis, imaging is crucial to confirm the diagnosis, the type of cellulitis and plan the appropriate surgical treatment. The first step of treatment will be the quick start of a broad spectrum intravenous antibiotic therapy, targeting aerobic and anaerobic bacteria. However, it seems imperative to associate a surgical treatment consisting in a first step of an oral drainage and an elimination of the oral infectious source, as well as an orbital drainage whose approach will have been determined by the imaging. Conclusion: Orbital cellulitis is a rare complication of oral cavity infections, but it must be recognized and treated in time to avoid serious morbidity. An early medical and surgical treatment will usually allow good results and a healing process without sequelae.

show abstract

Odontogenic Abscess With Orbital Extension Through the Inferior Orbital Fissure Treated With Bony Decompression

Cited by 4 publications

References 14 publications

Odontogenic orbital cellulitis. Case report and review of literature

Odontogenic orbital cellulitis. Case report and review of literature

Complications of Severe Odontogenic Infections: A Review

Odontogenic orbital cellulitis: literature review

Contact Info

Product

Resources

About