Extended pterional orbital decompression in severe orbital cellulitis.
BACKGROUND
Bacterial orbital cellulitis is a relatively uncommon infective process, which can threaten the function of orbital structures. Apart from antibiotic therapy, sinus surgery with or without abscess drainage via an orbito-otorhinolaryngological approach might be necessary.


METHODS
We present three cases of severe orbital cellulitis, leading to increasing loss of vision, proptosis, afferent pupillary disturbances and restriction of extra-ocular movements, despite antibiotic therapy. After extended pterional orbital decompression and reducing the orbital pressure by removal of the lateral and superolateral orbital walls, all patients showed distinct improvement of initial symptoms, without any complications related to the operation.


CONCLUSIONS
Extended pterional orbital decompression represents an effective treatment alternative and supplement in cases of a severe, threat to ocular function due to orbital cellulitis, where acute reduction of pressure on orbital, neural and vascular structures is intended.
Department of Neurosurgery, University Hospital RWTH Aachen, Germany.
M C
MC
Korinth
M R
MR
Weinzierl
W
W
Banghard
J M
JM
Gilsbach
D000328:Adult; D002481:Cellulitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D019299:Decompression, Surgical; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D011008:Pneumococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000601:surgery; D011859:Radiography; D012720:Severity of Illness Index; D013100:Sphenoid Bone / Q000000981:diagnostic imaging / Q000473:pathology / Q000601:surgery*; D013203:Staphylococcal Infections / Q000150:complications* / Q000175:diagnosis / Q000601:surgery