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 language | English (US) |
|---|---|
| Pages (from-to) | 115-120 |
| Number of pages | 6 |
| Journal | Orbit |
| Volume | 34 |
| Issue number | 3 |
| DOIs | |
| State | Published - Jun 1 2015 |
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Keywords
- Microbiology
- Orbital cellulitis
- Sinusitis
- Subperiosteal abscess
ASJC Scopus subject areas
- Ophthalmology
Cite this
Orbital cellulitis and subperiosteal abscess : A 5-year outcomes analysis. / Erickson, Benjamin P.; Lee, Wendy.
In: Orbit, Vol. 34, No. 3, 01.06.2015, p. 115-120.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Orbital cellulitis and subperiosteal abscess
T2 - A 5-year outcomes analysis
AU - Erickson, Benjamin P.
AU - Lee, Wendy
PY - 2015/6/1
Y1 - 2015/6/1
N2 - 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±1.3mm3 vs. 0.7±0.5mm3, 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.
AB - 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±1.3mm3 vs. 0.7±0.5mm3, 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.
KW - Microbiology
KW - Orbital cellulitis
KW - Sinusitis
KW - Subperiosteal abscess
UR - http://www.scopus.com/inward/record.url?scp=84931081087&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84931081087&partnerID=8YFLogxK
U2 - 10.3109/01676830.2014.950286
DO - 10.3109/01676830.2014.950286
M3 - Article
VL - 34
SP - 115
EP - 120
JO - Orbit
JF - Orbit
SN - 0167-6830
IS - 3
ER -