Odontogenic orbital cellulitis.
OBJECTIVE
To describe a small series of patients with odontogenic orbital cellulitis and review the visual outcomes of such patients reported in the scientific literature.


METHODS
Review of medical records and the scientific literature. Measured parameters included gender, age, days to presentation and surgery, the need for surgical intervention(s), sinus and orbital involvement on CT imaging, and pathogens involved.


RESULTS
Current cases and review of the scientific literature resulted in 24 patients with odontogenic orbital cellulitis and adequate examinations for statistical analysis. Twelve of 24 patients had preserved vision (final vision better than 20/70), whereas 11 of 24 patients had vision loss (final vision of light perception or no light perception). Analysis of data showed no statistical correlation between visual loss and age (p = 0.81), days to clinical presentation (p = 0.45), days to surgical exploration (p = 0.96), sinus radiographic involvement (p = 0.50), orbital radiographic findings (p = 0.19), or type of bacterial infection (Gram-positive aerobic vs. anaerobic organisms), (p = 0.31 and p = 0.50 respectively). Male gender, the need for surgical drainage, and multiple surgical procedures performed correlated statistically with loss of vision (p = 0.05, p = 0.03, and p = 0.02, respectively).


CONCLUSIONS
Multiple case reports have demonstrated that orbital cellulitis from an odontogenic source can result in devastating visual loss. Male gender, the need for surgical drainage, and multiple surgical procedures correlated statistically with severity of visual loss.
Youssef
Omaya H
OH
Wills Eye Institute, Thomas Jefferson University, Philadelphia, Pennsylvania 19107, USA. oculoplastics@hotmail.com
Stefanyszyn
Mary A
MA
Bilyk
Jurij R
JR
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003131:Combined Modality Therapy; D004359:Drug Therapy, Combination; D005260:Female; D005491:Focal Infection, Dental / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D054517:Orbital Cellulitis / Q000000981:diagnostic imaging / Q000209:etiology* / Q000628:therapy; D010254:Paranasal Sinus Diseases / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents