Korean J Otolaryngol-Head Neck Surg.  2003 Jul;46(7):575-579.

Clinical Analysis of Orbital Subperiosteal Abscesses as a Complication of Acute Sinusitis

• Kim JW
• Ahn SK
• Jeon SY
• Kim JP
• Kim BG

Abstract

BACKGROUND AND OBJECTIVES
Orbital complications of sinusitis are uncommon but can result in significant morbidity if not appropriately managed. We have experienced 8 cases of orbital subperiosteal absces- ses (SPA) as a complication of acute sinusitis. The purposes of our study are to assess the clinical features, diagnosis, isolated bacteria, and therapeutic results. MATERIALS AND METHOD: Eight patients with acute rhinosinusitis and orbital SPA who had been treated between April 1989 and September 2002 were retrospectively studied with medical records and CT. RESULTS: The most common symptoms and signs were proptosis and opthalmoplegia, and five patients (62%) complained of ocular pain or periorbital erythema. Seven patients (87%) complained of diplopia. We carried out medical treatment in 4 cases and surgical intervention in 4 cases. All patients were cured without complications. Streptococcus intermedius was isolated from 1 case and peptostreptococcus species from another but there was no growth of bacteria in 2 cases. CONCLUSION: Conservative treatment with intravenous antibiotics, topical nasal decongestants are the appropriate initial management in orbital SPA. In cases of medially located SPA of orbit, we recommend endoscopic surgical drainage because it does not require an external incision and has less postoperative edema.

Keyword

Sinusitis; Orbit; Abscess

MeSH Terms

Abscess*
Anti-Bacterial Agents
Bacteria
Diagnosis
Diplopia
Drainage
Edema
Erythema
Exophthalmos
Humans
Medical Records
Nasal Decongestants
Orbit*
Peptostreptococcus
Retrospective Studies
Sinusitis*
Streptococcus intermedius
Anti-Bacterial Agents
Nasal Decongestants