Pitfalls in the endoscopic drainage of subperiosteal orbital abscesses secondary to sinusitis.
OBJECTIVE
To review the safety and efficacy of endoscopic drainage of subperiosteal orbital abscesses (SPOAs) secondary to sinusitis and to evaluate risk factors that may be associated with failure.


METHODS
Retrospective chart review.


METHODS
All patients admitted to the University of the Virginia Health System with a diagnosis of SPOA between 1992 and 1999 were reviewed.


RESULTS
Seven of the 10 SPOAs identified, each located medially, resolved without complication after endoscopic drainage. The remaining three patients required a second drainage. One patient had an inferiorly located SPOA, which recurred laterally after endoscopic drainage. A second pediatric patient, who did not undergo a routine second-look procedure, developed middle turbinate lateralization and synechiae, which led to recurrent SPOAs. A third patient with a significant history of sinusitis was found to have an ethmoid sinus mucocele extending into the medial and posterior orbit. All patients eventually resolved their symptoms.


CONCLUSIONS
Endoscopic drainage of medial SPOAs appears to be safe and effective. However, several risk factors must be recognized when present. Management of these risk factors is discussed.
Noordzij
J Pieter
JP
Department of Otolaryngology-Head and Neck Surgery, University of Virginia Health Sciences Center, Charlottesville 22908-0713, USA.
Harrison
Scott E
SE
Mason
John C
JC
Hashisaki
George T
GT
Reibel
James F
JF
Gross
Charles W
CW
D000038:Abscess / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D009916:Orbital Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D012189:Retrospective Studies; D012852:Sinusitis / Q000150:complications*; D014057:Tomography, X-Ray Computed; D017211:Treatment Failure