Orbital cellulitis and subperiosteal abscess: A 5-year outcomes analysis

Benjamin P. Erickson, Wendy Lee

Research output: Contribution to journalArticle

13 Scopus citations

Abstract

Purpose: Orbital cellulitis and subperiosteal abscess (SPA) are historically associated with poor outcomes. We seek to characterize current associations with abscess formation, surgical failure and vision loss. Methods: All cases of orbital cellulitis presenting to an affiliated hospital between April 2008 and 2013 were critically reviewed. Results: Thirty patients met inclusion criteria. Average age was 28.7±24.4. The male to female ratio was 2:1. Abscesses were identified in 56.7% of patients. Adults were less likely than children to present with abscesses (28.6% vs. 81.3%, p=0.008). Of the other factors analyzed, only antibiotic use before admission (70.5% vs. 23.1%, p=0.03) and maximum restriction (-2.5±1.2 vs. -0.9±0.7, p=0.008) were associated with SPA. Temperature at presentation (37.9±0.9 vs. 37.1±0.4, p=0.04), relative proptosis (5.8±3.3mm vs. 2.1±1.1, p=0.002) and abscess volume (4.3±1.3mm<sup>3</sup> vs. 0.7±0.5mm<sup>3</sup>, p=0.0004) were associated with progression to surgery. Reoperation was required in 26.7% of patients. Of these, two-thirds had combined superior/medial abscesses that re-accumulated after isolated endonasal surgery. Two of the 3 patients with profound vision loss had a dental etiology. Conclusions: Only young age, prior antibiotics and degree of restriction predicted the presence of an abscess. Re-accumulation was more common than anticipated, and drainage of superior/medial abscesses by endoscopic surgery alone had the strongest association with surgical failure. Patients with odontogenic abscesses must be treated with particular caution.

Original languageEnglish (US)
Pages (from-to)115-120
Number of pages6
JournalOrbit
Volume34
Issue number3
DOIs
StatePublished - Jun 1 2015

Keywords

  • Microbiology
  • Orbital cellulitis
  • Sinusitis
  • Subperiosteal abscess

ASJC Scopus subject areas

  • Ophthalmology

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