Transnasal endoscopic drainage of a medial subperiosteal orbital abscess.
The exact incidence of orbital complications due to sinusitis in children is unknown. However, a medial subperiosteal orbital abscess is the most common serious complication to occur. Surgical intervention is mandatory whenever antibiotic treatment fails. Most authors prefer open surgical procedures such as external ethmoidectomy, while others recommend transnasal endoscopic drainage as the first attempt at sinus decompression. Five out of 12 children with proven subperiosteal orbital abscess and sinusitis on computed tomographic scans failed antibiotic treatment and required surgical drainage. Transnasal endoscopic drainage of the abscess was performed on four patients, while one child underwent external ethmoidectomy. Our experience with endoscopic surgery in these four cases is discussed, along with a brief review of the advantage of this procedure over external surgery.
Department of Otolaryngology, Assaf Harofeh Medical Center, University of Tel Aviv, Zerifin, Israel.
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Kessler
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LP
Berenholz
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S
Segal
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000293:Adolescent; D019980:Amoxicillin-Potassium Clavulanate Combination / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002444:Cefuroxime / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004322:Drainage; D004359:Drug Therapy, Combination / Q000627:therapeutic use; D004724:Endoscopy; D005004:Ethmoid Bone / Q000601:surgery; D015521:Ethmoid Sinusitis / Q000150:complications; D005260:Female; D015522:Frontal Sinusitis / Q000150:complications; D006801:Humans; D008297:Male; D015523:Maxillary Sinusitis / Q000150:complications; D009666:Nose; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D010521:Periosteum; D012852:Sinusitis / Q000150:complications / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D019980:Amoxicillin-Potassium Clavulanate Combination; D002444:Cefuroxime