SUBPERIOSTEAL ORBITAL ABSCESS COMPLICATING FRONTAL SINUSITIS IN A CHILD

• Main Author: Belgacem, Hajer Ben
• Format: Web Resource
• Language: English
• Published: Morressier 01.01.2017

Superolateral subperiosteal orbital abscess complicating frontal sinusitis in a child : a case reportA. Tej1, H. Ben Belgacem1, R. Kbaili1, F. Ferhi2, S. Tilouche1, N. Kahloul1, J. Bouguila1, L. Boughamoura1.1Farhat Hached Hospital, pediatric, Sousse, Tunisia.2Farhat Hached Hospital, department of anesthesia, Sousse, Tunisia.Background A superolateral subperiosteal orbital abscess is a collection of purulent material between theperiorbit and the superior bony orbital wall, and is typicallya complication of frontal sinusitis.Case report :A 14-year-old boy presented with a 3 day history of frontal headache and progressive painful right eye swelling. Initial examination revealed a temperature of 39u00b0C.There was extensive cellulitis involving the rightupper eyelid with exophthalmia and ophthalmoplegiaon upward gaze. Percussion showed tenderness localizedin the right frontal sinus. Visual acuity and fundus examination were both normal. Orbital CTscanrevealed right superolateral orbitalabscess with periorbital cellulitis and frontal sinusitis.Initial intravenous antibiotic treatment was unsuccessful. The decision was taken to proceed to surgical drainage by a maxillofacial Surgeon. A superior lid incision wasperformed. Duringoperation ; communication between frontal sinus and orbital cavity was found. The pus culture was negative.The improvement was remarkable and the postoperative course remained uneventful.Conclusion :The superolaterally located subperiosteal abscess due to frontal sinusitis has not been commonly reported in children. Congenital bony dehiscences exist in the lateral floor of the frontal sinus, which may allow direct spread of infection through to that region.An early diagnosis and adequate infection control are of upmost importance in order to avoid potential visual and deadly complications.