Conservative Management for Subperiosteal Orbital Abscess in Adults: A 20-Year Experience.

Authors:
Haim Gavriel
Haim Gavriel
Tel Aviv University
Israel
Basel Jabarin
Basel Jabarin
Assaf Harofe Medical Center
Ofer Israel
Ofer Israel
Assaf Harofeh Medical Center
באר יעקב | Israel
Ephraim Eviatar
Ephraim Eviatar
Tel Aviv University
Israel

Ann Otol Rhinol Laryngol 2018 Mar 3;127(3):162-166. Epub 2018 Jan 3.

1 Department of Otolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin, Israel.

Objective: Orbital complications (OC) secondary to acute rhinosinusitis (ARS) in adults are less common than in children, with assumed worse outcome.

Materials And Methods: Adults with OC secondary to ARS between 1994 and 2014 were reviewed retrospectively. Parameters recorded included age, gender, clinical symptoms and signs, computed tomography (CT) scan findings, duration of hospitalization, treatment before and during admission, cultures, and outcome.

Results: Thirty-seven adults with a mean age of 34.6 years, 27 males and 10 females, were diagnosed with OC, 19 (51.3%) with subperiosteal orbital abscess (SPOA), and none with orbital abscess/cellulitis or cavernous sinus thrombosis. Twelve patients with SPOA were managed conservatively with Amoxicillin-Clavulanate in most cases, and only 7 (36.8%) underwent surgery. A CT scan was performed in 27 cases revealing rhinosinusitis in all patients, including frontal involvement in 19 (51.3%) patients and sphenoid sinus in 16 (43.2%).

Conclusions: A shift toward conservative treatment in cases of SPOA has long been integrated in the management protocols, mainly in children under 9 years old. The presumed worse prognosis in adults is not supported in our study, and a conservative treatment is urged to be considered in this group of patients albeit the more extensive radiologic involvement of their sinuses.
PDF Download - Full Text Link
( Please be advised that this article is hosted on an external website not affiliated with PubFacts.com)
Source Status
http://dx.doi.org/10.1177/0003489417751155DOI ListingPossible
March 2018
6 Reads

Similar Publications

Conservative treatment in rhinosinusitis orbital complications in children aged 2 years and younger.

Rhinology 2008 Dec;46(4):334-7

Department of Otorhinolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Israel.

Objective: Orbital complications (OC) secondary to acute rhinosinusitis (ARS) in children are uncommon, but can result in severe morbidity and mortality if not treated appropriately. These complications are more common in older children. We evaluate the disease and its management in children aged 2 and under. Read More

View Article
December 2008

[Orbital complications of sinusitis].

Cesk Slov Oftalmol 2014 Dec;70(6):234-8

Orbital complications categorised by Chandler are emergency. They need early diagnosis and agresive treatment. Stage and origin of orbital complications are identified by rhinoendoscopy, ophtalmologic examination and CT of orbite and paranasal sinuses. Read More

View Article
December 2014

Management of superior subperiosteal orbital abscess.

Eur Arch Otorhinolaryngol 2016 Jan 21;273(1):145-50. Epub 2015 Feb 21.

Department of Otorhinolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, 70300, Zerifin, Israel.

A superior subperiosteal orbital abscess (SSPOA) is a collection of purulent material between the periorbit and the superior bony orbital wall, and is typically a complication of frontal sinusitis. SSPOA is characteristically managed by classic external surgical drainage. The aim of our study was to assess the role of surgical intervention in SSPOA. Read More

View Article
January 2016

Is pyogenic ethmoidal osteitis the cause of complicated rhinosinusitis with subperiosteal orbital abscess?

Eur Arch Otorhinolaryngol 2010 Aug 13;267(8):1231-7. Epub 2010 Jan 13.

Department of ORL Head and Neck Surgery, Menoufyia University Hospital, Shibin Elkom, 73, Sayed St., Tanta, Egypt.

Multiple theories were described concerning the pathogenesis of orbital infection in rhinosinusitis, but no theory was proved. Understanding the cause of complication can allow its proper management. We speculate that subperiosteal orbital abscess (SPOA) secondary to rhinosinusitis is similar to subperiosteal abscess associated with osteomyelitis of bone all over the body. Read More

View Article
August 2010