Orbital cellulitis and subperiosteal abscess

A 5-year outcomes analysis

Benjamin P. Erickson, Wendy Lee

Research output: Contribution to journalArticle

8 Citations (Scopus)

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

Fingerprint

Orbital Cellulitis
Abscess
Anti-Bacterial Agents
Exophthalmos
Reoperation
Drainage
Tooth

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 journalArticle

Erickson, Benjamin P. ; Lee, Wendy. / Orbital cellulitis and subperiosteal abscess : A 5-year outcomes analysis. In: Orbit. 2015 ; Vol. 34, No. 3. pp. 115-120.
@article{a92b2f350912486489eff60f54102893,
title = "Orbital cellulitis and subperiosteal abscess: A 5-year outcomes analysis",
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±1.3mm3 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.",
keywords = "Microbiology, Orbital cellulitis, Sinusitis, Subperiosteal abscess",
author = "Erickson, {Benjamin P.} and Wendy Lee",
year = "2015",
month = "6",
day = "1",
doi = "10.3109/01676830.2014.950286",
language = "English (US)",
volume = "34",
pages = "115--120",
journal = "Orbit",
issn = "0167-6830",
publisher = "Informa Healthcare",
number = "3",

}

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 -