title: Endoscopic drainage of orbital abscesses aided with intraoperative sonography.
abstract: OBJECTIVE
  Accurate localization and adequate visualization of the superiorly or inferiorly located subperiosteal orbital abscesses or intraorbital abscess is difficult with transnasal endoscopic approach. Sonography is a well-known and effective tool for evaluation of orbital pathologies but no paper documenting intraoperative application of this method in orbital abscess surgery has been published to date.
  
  
  METHODS
  We present a series of 12 patients in whom orbital abscesses were drained endoscopically with an aid of neuronavigation and intraoperative ultrasonography. The abscesses were localized subperiosteally in the medial (n=6), superior (n=2) or inferior (n=1) part of the orbit whereas in 3 patients the abscess was localized in the intraconal space.
  
  
  RESULTS
  According to intraoperative sonographic imaging complete drainage of the abscess was achieved in 11 out of 12 patients and no complications occurred. Intraoperative sonography helped to limit opening of the orbital wall in the medial subperiosteal abscesses, enabled check-up for completeness of drainage of the far extending pouches in the superior and inferior subperiosteal abscesses and enabled visualization of the tip of surgical instrument when reaching deeply located intraorbital abscesses.
  
  
  CONCLUSIONS
  Intraoperative ultrasonography facilitates the endoscopic management of orbital abscesses, especially those which are difficult to reach due to subperiosteal location in the superior and inferior parts of the orbit, or abscesses localized intraorbitally.
authors.affiliation: Department of Neurosurgery, Medical University of Bialystok, Bialystok, Poland. Electronic address: lyson_t@vp.pl.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Lyson
authors.affiliation: Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Sieskiewicz
authors.affiliation: Department of Neurosurgery, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Robert
authors.initials: R
authors.lastname: Rutkowski
authors.affiliation: Department of Neurosurgery, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Kochanowicz
authors.affiliation: Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Rozanska
authors.affiliation: Department of Otolaryngology, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Marek
authors.initials: M
authors.lastname: Rogowski
authors.affiliation: Department of Neurosurgery, Medical University of Bialystok, Bialystok, Poland.
authors.forename: Zenon
authors.initials: Z
authors.lastname: Mariak
mesh_terms: D000038:Abscess / Q000601:surgery*; D000293:Adolescent; D000328:Adult; D004322:Drainage / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009915:Orbit / Q000000981:diagnostic imaging* / Q000601:surgery*; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D055815:Young Adult
keywords: Endoscopy; Orbital abscess; Orbital ultrasonography; Surgical treatment