A retrospective study of surgically treated subperiosteal orbital abscesses derived from acute bacterial ethmoid sinusitis

J.H Therchilsen,A.T Bilde,A.A Muhamad,C Von Buchwald

doi:10.4193/rhinol/19.021

Abstract

A retrospective study of surgically treated subperiosteal orbital abscesses derived from acute bacterial ethmoid sinusitis

Highlights

A subperiosteal orbital abscess (SPOA) arises from acute sinusitis in acute ethmoiditis where the inflammation spreads through vascular channels or directly through bony dehiscence in lamina papyracea . [1,2] It is a disease capable of rapid progression, and both intracranial and orbital extensions can have vital consequences if not treated promptly and adequately
Our study showed that the subset of patients referred to our tertiary treatment centre swiftly received surgical treatment for their Subperiosteal abscesses (SPOA) when radiographically diagnosed and with a low level of recurrence and morbidity compared to other studies . [6,12] Due to our surgical treatment of all contrast-enhanced computed tomography (CECT)-confirmed SPOAs, we can present, to our knowledge, one of the largest retrospective studies of surgically treated SPOA secondary to acute sinusitis
Harris' seminal work in bacteriologic studies of SPOAs played a pivotal role in generating the idea of an initial medical approach for young children with SPOA . [16,18,22] The idea is based on bacteriological data suggesting that children under nine years of age experience more simple infections, more compliable with medical treatment, due in part to no presence of anaerobes growth . [18] This finding has been constant through a 35-yearlong bacteriologic study of surgically treated SPOAs . [17] In the Liao and Harris’ article on the bacteriology of SPOAs they point out that the bacteriology of medically treated SPOAs is unknown . [17] Since we operate all CT confirmed SPOAs, we can present a complete bacteriologic description, though limited by negative culture results

Summary

Introduction

A subperiosteal orbital abscess (SPOA) arises from acute sinusitis in acute ethmoiditis where the inflammation spreads through vascular channels or directly through bony dehiscence in lamina papyracea . [1,2] It is a disease capable of rapid progression, and both intracranial and orbital extensions can have vital consequences if not treated promptly and adequately. SPOA, as a complication of acute bacterial rhinosinusitis (ABRS), Surgical management of subperiosteal abscesses due to acute ethmoid sinusitis possesses a threat if it is left untreated. It might result in blindness, meningitis, cerebral abscess, and death . In 1970 Chandler et al [3] described and classified orbital complications derived from ARS (Table 1). This classifications system remains the preferred analytic tool for assessing the severity of orbital complications and ensures homogeneity in both research and clinical study. Subperiosteal abscesses (SPOA) are a complication of acute purulent sinusitis, and their optimal treatment regime is a controversial topic. The purpose of this study was to evaluate our current treatment guidelines for subperiosteal abscesses

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Discussion

Conclusion