Subperiosteal abscesses of the orbit due to sinusitis in childhood

Abstract

This paper reports 16 cases of subperiosteal abscesses of the orbit due to acute sinusitis in childhood. They comprise 12.4% of 129 patients presenting with an 'acute orbit'. Acute ethmoidal sinusitis was the predominant cause. The typical clinical features, as well as CT scanning of the paranasal sinuses, orbit and brain, should assist in early diagnosis. If possible, the subperiosteal abscess and sinuses should be drained before loss of visual acuity or intracranial complications occur. Streptococcus milleri was the pathogen most commonly cultured. One patient in this series had intracranial complications, but no other patients had major complications and there were no deaths.

Near-fatal subdural empyema complicating a rapidly progressive orbital cellulites

“…Frontal sinusitis is rare before the age of 7 years as the frontal sinuses have not usually formed till this age. [56] In a study of children between the ages of 3 and 14 who had CTs for rhinosinustis, only 7% of the 7–8-year-olds had frontal sinusitis compared with 15% of the 11–12-year-olds. [5] The mode of disease spread from the frontal sinus to the superior lateral SPOA is postulated to be via bacterial thrombophlebitis through valveless veins, through bony erosion or via congenital or acquired bony dehiscence.…”