Paranasal sinus infection causing orbital subperiosteal abscess: surgical management of this devastating entity

Oral Maxillofac Surg. 2013 Jun;17(2):131-5. doi: 10.1007/s10006-012-0343-8. Epub 2012 Jul 31.

Abstract

Background: Orbital infection is an uncommon devastating infection and is usually a complication of paranasal sinus infection. Without appropriate treatment, orbital infection may lead to serious complications, even death. Prompt treatment is mandatory to avoid visual loss or intracranial complications. The literature shows that initially, intravenous antibiotics should be administered, and after 48 h, if no improvement appears, the affected orbit and the sinuses must be surgically drained. The authors describe two cases of orbital cellulitis with a brief literature review.

Case report: The authors describe two cases of orbital abscess caused by paranasal sinus infection. In case 1, the patient presented a decreased visual acuity associated with ophthalmoplegia of the right eye. In case 2, the patient presented a decreased visual acuity. Thus, administration of intravenous antibiotic combined with surgical drainage was performed. After surgical procedure, eye movements were normalized in case 1, and in both patients, the visual acuity returned to normal parameters.

Discussion: The authors recommend early surgical drainage with parenteral antibiotic administration and careful postoperative observations by monitoring the signs and symptoms of the orbital complaint.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnosis
  • Abscess / etiology*
  • Abscess / surgery
  • Adolescent
  • Anti-Bacterial Agents / therapeutic use
  • Brazil
  • Child
  • Combined Modality Therapy
  • Female
  • Humans
  • Magnetic Resonance Imaging
  • Ophthalmoplegia / etiology
  • Orbital Cellulitis / diagnosis
  • Orbital Cellulitis / etiology*
  • Orbital Cellulitis / surgery
  • Periostitis / diagnosis
  • Periostitis / etiology*
  • Periostitis / surgery
  • Postoperative Care
  • Sinusitis / complications
  • Sinusitis / diagnosis
  • Sinusitis / surgery
  • Tomography, X-Ray Computed
  • Visual Acuity

Substances

  • Anti-Bacterial Agents