The case of sinogenic subperiosteal abscess without symptoms of sinusitis

Abstract

Orbital infection occurs when pathogens pass from an infected sinus into the orbit. The inflammation is spreading onto the orbital structures from the surrounding tissues mainly from ethmoidal sinuses due to its specific anatomical conditions. The orbital complications are preseptal cellulitis, orbital cellulitis, subperiosteal abscess, orbital abscess, and intracranial infections. The diagnosis of subperiosteal orbital abscess is based mainly on clinical presentation. The symptoms depends on which sinus is affected. Orbital symptoms include periorbital swelling, proptosis, ophthalmoplegia, chemosis, and optic nerve compression. Computer tomography is mandatory. Early diagnosis and appropriate treatment can prevent from permanent vision loss and intracranial complication. The study discusses the course of the disease of a 25-year-old woman who was admitted to the Emergency Department due to inflammatory eyelid oedema and proptosis for 3 days. No symptoms of sinusitis were noted. The CT scans established diagnosis - subperiosteal orbital abscess. The patient was treated with broad-spectrum antibiotics and functional endoscopic sinus surgery. Her treatment and recovery were uneventful. In follow-up nighter ophthalmological nor otorhinolaryngological complains were noted.