Endoscopic vs external drainage of orbital subperiosteal abscess
E. L. Page and B. J. Wiatrak
Division of Otolaryngology-Head and Neck Surgery, University of Alabama at Birmingham, USA.
Periorbital cellulitis is frequently limited to the preseptal region.
However, there may be associated postseptal inflammation and orbital
subperiosteal abscess (SPA). Surgical management of orbital SPA includes
open drainage through an external ethmoidectomy approach, although recently
the use of endoscopic techniques has been reported. This study was
undertaken to evaluate postseptal cellulitis and orbital SPA in patients
with periorbital cellulitis and to assess the safety and effectiveness of
endoscopic management of orbital SPA. From 1989 through 1994, 158 patients
were admitted with a diagnosis of periorbital cellulitis. Nineteen of these
patients were diagnosed with postseptal orbital inflammation, and 14
underwent surgical drainage via an external approach, an endoscopic
approach, or a combination of both. Issues addressed include (1) the role
of sinus disease as the cause of periorbital cellulitis; (2) the role of
computed tomographic scanning; (3) the effectiveness of aggressive medical
therapy; and (4) the results of endoscopic drainage of orbital SPA compared
with the external approach.
