Sinogenic orbital complications

Welkoborsky, Hans-J.; Pitz, Susanne; Graß, SK; Breuer, B.; Holte, Anja Pähler vor der; Bertram, Oliver; Wiechens, Burkhard

doi:10.3238/arztebl.m2021.0379

Cited by 14 publications

(13 citation statements)

References 59 publications

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“…2,25,26 Although both can affect visual acuity, pupillary response, and IOP, OA tends to impair ophthalmic function more severely than SPA at presentation. 3,11,27 EOM limitation was the most common presenting sign in the present study, followed by decreased visual acuity in the OA group and elevated IOP in the SPA group. Prevalence of RAPD and decreased visual acuity were significantly higher in the OA cohort, but no presenting feature was reliably predictive of SPA versus OA.…”

Section: Discussionsupporting

confidence: 51%

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Gibbons,

Niknahad,

Bacorn

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To compare the clinical features, management, and outcomes between orbital cellulitis patients with subperiosteal abscess (SPA) and those with orbital abscess (OA). Methods: A retrospective study was conducted at a tertiary care center through medical record search to identify patients with orbital cellulitis from January 1, 2000 to December 31, 2022. Charts were screened for those with radiographic evidence of SPA or OA. Demographic data and presenting clinical features were compared between the 2 cohorts. Primary outcomes compared included rates of surgical intervention, reoperation, and readmission; and length of hospital stay and final vision. Results: A total of 189 patients, 162 with SPA and 27 with OA, met the criteria. The OA group (mean 46.5 ± 18.6 years) was older than the SPA group (mean 19.1 ± 21.4 years). Comorbid sinusitis was significantly more common in the SPA cohort (95.7% SPA; 70.4% OA; p < 0.001), while OA was more likely to occur with orbital trauma (29.6% vs. 8.0%; p = 0.003), implanted hardware (11.1% vs. 0.6%; p = 0.005), and comorbid diabetes (22.2% vs. 4.3%; p = 0.001). OA patients more often presented with a relative afferent pupillary defect (21.7% vs. 3.9%; p = 0.005), vision worse than 20 of 50 (42.3% vs. 16.2%; p = 0.005), and methicillin-resistant Staphylococcus aureus infection (20.8% vs. 5.8%; p = 0.036). OA was associated with a higher reoperation rate (47.8% vs. 21.3%; p = 0.019), readmission rate (18.5% vs. 5.6%, p = 0.047), and limited extraocular motility at follow-up (4.3% vs. 25%; p = 0.013); while mean length of hospital stay and final visual acuity were similar. Conclusion: OA may affect an older population with a divergent risk factor profile compared with SPA. OA may cause more severe functional impairment on presentation, warranting more aggressive management to achieve visual outcomes similar to SPA.

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Section: Discussionsupporting

confidence: 51%

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Gibbons,

Niknahad,

Bacorn

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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“…Eine ausführliche weiterführende Darstellung der Symptomatik von Orbitaerkrankungen findet sich auch im Lehrbuch Orbita von Welkoborsky et al 2 .…”

Section: Symptomatikunclassified

Maligne Neoplasien der Orbita

Bertelmann,

von Sonnleithner

2023

Augenheilkunde up2date

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ZusammenfassungWeil die Erstsymptomatik maligner Neoplasien der Orbita häufig das Auge betrifft (Exophthalmus, Diplopie, Schmerzen), ist der Augenarzt häufig der erste mit der Problematik des jeweiligen Krankheitsbildes konfrontierte Arzt, von dessen Kenntnissen, richtiger Einordnung und richtigen weiteren Entscheidungen die adäquate weitere Therapiesteuerung und die Prognose des Patienten entscheidend abhängen.

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“…Schließlich hängt die Wahl des passenden Zugangs von der Topografie der Orbita und der Volumenverteilung der orbitalen Gewebe ab ( Abb. 1 aus 4 ). Eine Präparation in Arealen, in denen sich überwiegend Fett befindet, ist risikoloser als in Kompartimenten mit hoher Dichte an Nerven, Gefäßen oder Muskeln.…”

Section: Kriterien Für Die Wahl Des Geeigneten Zugangsunclassified

“…Finally, the choice of appropriate access depends on the topography of the orbit and the volume distribution of the orbital tissue ( Fig. 1 from 4 ). It is safer to perform the preparation in areas predominantly consisting of fat than in compartments that have a high density of nerves, vessels, or muscle.…”

Section: Criteria For Choosing the Appropriate Approachmentioning

confidence: 99%

Ophthalmologische und interdisziplinäre chirurgische Zugänge zur Orbita

Bertelmann

2023

Klin Monbl Augenheilkd

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ZusammenfassungDie Behandlung orbitaler Raumforderungen erfordert oft einen interdisziplinären Ansatz. Zu den ophthalmologischen chirurgischen Ansätzen gehört der vordere transkutane Zugang zur Entfernung von Dermoiden oder zur Gewinnung von Biopsien. Die anteriore transkonjunktivale Orbitotomie eignet sich für Raumforderungen der unteren Orbita oder des intrakonalen Kompartiments, nicht jedoch für Raumforderungen der Orbitaspitze. Die laterale transossäre Orbitotomie eignet sich häufig am besten für Raumforderungen des lateralen oder intrakonalen Kompartiments, insbesondere für Neoplasien der Tränendrüse, z. B. pleomorphes Adenom. Bei kavernösen Hämangiomen aller Lokalisationen kann die Kryoextraktion ein geeignetes technisches Hilfsmittel sein. Transfrontale Zugänge sind zur Resektion von Tumoren des N. opticus und der Orbitaspitze geeignet.

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Sinogenic orbital complications

Cited by 14 publications

References 59 publications

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Subperiosteal and Orbital Abscesses: A Comparison of Clinical Features, Management, and Outcomes

Maligne Neoplasien der Orbita

Ophthalmologische und interdisziplinäre chirurgische Zugänge zur Orbita

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