title: Drainage of subperiosteal orbital abscesses complicating pediatric ethmoiditis: comparison between external and transnasal approaches.
abstract: OBJECTIVE
  The aim of the present study was to compare the external (EA), transnasal endoscopic (TEA), and combined (CA) external and transnasal approaches to drain orbital subperiosteal abscesses complicating pediatric ethmoiditis.
  
  
  METHODS
  This retrospective study included 38 children consecutively operated in our center for an orbital subperiosteal abscess complicating an acute ethmoiditis. The distribution of surgical approaches used for our patients was the following: 12 TEA (32%), 21 EA (55%) and 5 CA (13%). All data were retrieved from patients' clinical charts.
  
  
  RESULTS
  No surgical complication was observed in the present study regardless of the approach. The percentage of surgical failures requiring additional drainage was almost twice as high after TEA (failure rate: 25%) than after EA (failure rate 14.3%), but this difference was not significant. Parameters which significantly influenced the risk of failure of TEA were the length and width of the abscess. The duration of postoperative hospitalization was significantly lower in the TEA group (3.1 days) than in the EA one (5.4 days). There were no failures in the CA group.
  
  
  CONCLUSIONS
  Failures of surgical drainage of orbital subperiosteal abscess complicating pediatric ethmoiditis are not rare and did not differ between external and transnasal endoscopic approaches in our study. The transnasal route is associated with a shorter postoperative duration of postoperative hospitalization. CA seems to be a viable surgical option combining the advantages of both endoscopic and external approaches.
authors.affiliation: Pediatric ENT Department, Hôpital Necker - Enfants Malades, AP-HP, Université Paris V, France.
authors.forename: F
authors.initials: F
authors.lastname: Rubin
authors.forename: S
authors.initials: S
authors.lastname: Pierrot
authors.forename: M
authors.initials: M
authors.lastname: Lebreton
authors.forename: P
authors.initials: P
authors.lastname: Contencin
authors.forename: V
authors.initials: V
authors.lastname: Couloigner
mesh_terms: D000038:Abscess / Q000209:etiology* / Q000601:surgery; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004322:Drainage / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D015521:Ethmoid Sinusitis / Q000150:complications* / Q000601:surgery; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D009666:Nose / Q000601:surgery*; D009916:Orbital Diseases / Q000209:etiology* / Q000601:surgery; D012189:Retrospective Studies; D017211:Treatment Failure; D016896:Treatment Outcome