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, 4 (3), 314-7

Management of Odontogenic Orbital Cellulitis

Case Reports

Management of Odontogenic Orbital Cellulitis

F C DeCroos et al. J Med Life.


This work describes a series of patients with odontogenic orbital cellulitis (OOC), focusing on rate of abscess formation, need for surgical intervention, and imaging findings helpful for rapid diagnosis. Review of a current case and 22 patients with OOC from the scientific literature demonstrated periapical lucency as the most commonly (36.4%) reported finding on facial and orbital computerized tomography (CT) scan. Orbital abscess occurred in 72.7% of cases, and tooth extraction and/or abscess drainage was required in 95.5% of cases reviewed for control of infection. The current case presented with periapical lucency on CT scan, developed orbital abscess despite broad spectrum antibiotic therapy, and required multiple surgical interventions for disease resolution. Though our patient regained excellent vision, OOC often can result in severe vision loss. Periapical lucency on CT can help identify this atypical origin of cellulitis that is strongly associated with abscess formation and need for surgical intervention.

Keywords: abscess; dental complications; infection; orbital cellulitis; tooth.


Figure 1
Figure 1
Axial CT scan (admission) shows right proptosis and facial soft tissue swelling
Figure 2
Figure 2
Axial CT scan (admission) shows bilateral periapical dental granulomas
Figure 3
Figure 3
Coronal CT scan (admission) shows deterioration of right maxillary sinus floor
Figure 4
Figure 4
Coronal CT scan (admission) shows orbital emphysema continuous with the right inferior rectus and thickening of the adjacent maxillary sinus
Figure 5
Figure 5
Repeat axial CT scan (hospital day 4) shows a right inferior orbital abscess

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Cited by 4 PubMed Central articles


    1. Blake FA, Siegert J. The acute orbit: etiology, diagnosis, and therapy . J Oral Maxillofac Surg. 2006;64:87–93. - PubMed
    1. Nageswaran S. Orbital cellulitis in children . Pediatr Infect Dis J. 2006;25:695–699. - PubMed
    1. Zachariades N, Vairaktaris E. Orbital abscess: visual loss following extraction of a tooth–case report . Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2005;100:70–73. - PubMed
    1. Bullock JD, Fleishman JA. The spread of odontogenic infections to the orbit: diagnosis and management . J Oral Maxillofac Surg. 1985;43:749–755. - PubMed
    1. Youssef OH, Stefanyszyn MA. Odontogenic orbital cellulitis . Ophthal Plast Reconstr Surg . 2008;24:29–35. - PubMed

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