Management of orbital subperiosteal abscess.
OBJECTIVE
To discuss the role of surgical intervention in subperiosteal orbital abscess (SPOA) using a retrospective medical chart review.


METHODS
A retrospective medical chart review of subjects who were diagnosed and surgically treated for SPOA between 2002 and 2009.


RESULTS
Ten patients were identified (8 males and 2 females). All SPOAs were unilateral. Of 10 SPOAs, 7 were on the left and 3 were on the right. Six of these were medially located abscesses, whereas 4 were superior abscesses. Of the 6 medially located abscesses, 4 were treated with transnasal endoscopy (TNE). External (E) drainage was needed in 2 of the medially located abscesses. In one of these abscesses, the surgeon was forced to drain the abscess with TNE and turned to E drainage. In the other, TNE was performed first. Despite medical therapy and TNE, patients' orbital symptoms did not resolve. A second operation was performed with E drainage. Four of the superiorly based SPOAs were treated with combined E-TNE approach.


CONCLUSIONS
External drainage of the SPOA is needed on 6 (60%) of the patients in this study. Superiorly located abscesses were initially treated with E drainage, and then functional endoscopic sinus surgery was performed to treat the affected sinuses. Transnasal endoscopic management failed in 2 patients, hence E drainage was needed. The characteristics of the patients are presented and discussed in view of a surgical approach.
Kayhan
Fatma Tulin
FT
From the Bakirköy Education and Training Hospital, Clinic of Otorhinolaryngology, Head and Neck Surgery, Istanbul, Turkey.
Sayin
Ibrahim
I
Yazici
Zahide Mine
ZM
Erdur
Omer
O
D000038:Abscess / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D002648:Child; D004322:Drainage / Q000379:methods; D004724:Endoscopy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009916:Orbital Diseases / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D012086:Reoperation; D012189:Retrospective Studies; D012220:Rhinitis / Q000139:chemically induced; D012852:Sinusitis / Q000150:complications; D016896:Treatment Outcome