Management of pediatric orbital cellulitis in patients with radiographic findings of subperiosteal abscess.
OBJECTIVE
Controversies remain regarding the management of orbital cellulitis (OC). The objective of this study was to examine the outcomes of patients admitted to our institution for orbital cellulitis during a 7-year period.


METHODS
Case series with chart review.


METHODS
Tertiary referral pediatric hospital.


METHODS
Charts of 465 consecutive OC admissions were reviewed for presentation, imaging, medical and surgical treatment, and outcome.


RESULTS
Of these patients, 189 were treated in the emergency room and 276 were admitted. CT scan was performed on 240 patients. Subperiosteal abscess (SPA) was noted in 68 patients. Of these, 47 were treated medically and 21 had surgery. Surgical patients were older (8.3 vs 6.2 years, P = 0.039), had larger abscesses (>10 mm, P < 0.001), required a longer admission (10.2 vs 6.6 days, P < 0.001), and had higher temperatures on admission (38.0 degrees C vs 37.3 degrees C, P = 0.03).


CONCLUSIONS
The majority of small SPAs as diagnosed on CT scans in younger children can be successfully treated medically. Surgery, however, should be considered for a worsening clinical examination. Our findings confirm those of previous reports on this clinical entity.
Ryan
Jesse T
JT
Department of Otolaryngology, National Naval Medical Center, Bethesda, MD, USA.
Preciado
Diego A
DA
Bauman
Nancy
N
Pena
Maria
M
Bose
Sumit
S
Zalzal
George H
GH
Choi
Sukgi
S
D000038:Abscess / Q000000981:diagnostic imaging / Q000628:therapy*; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016009:Chi-Square Distribution; D002648:Child; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D054517:Orbital Cellulitis / Q000000981:diagnostic imaging / Q000628:therapy*; D010521:Periosteum; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents