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Superiorly based subperiosteal orbital abscess: an uncommon presentation
  1. Georgios Chrysovitsiotis1,
  2. Paraskevi Kollia1,
  3. Efthymios Kyrodimos1 and
  4. Aristeidis Chrysovergis2
  1. 11st Otorhinolaryngology Dpt, National and Kapodistrian University of Athens School of Medicine, Athens, Attiki, Greece
  2. 2ENT, National and Kapodistrian University of Athens School of Medicine, Athens, Attica, Greece
  1. Correspondence to Georgios Chrysovitsiotis; chrysovi{at}gmail.com

Abstract

A 32-year-old female patient presented with severe facial pain, right eye proptosis and diplopia. Endoscopy revealed ipsilateral crusting, purulent discharge and bilateral nasal polyps. Imaging demonstrated a subperiosteal abscess on the roof of the right orbit. Due to patient’s significant ocular manifestations, surgical management was decided. The abscess was drained using combined endoscopic and external approach, via a Lynch-Howarth incision. Following rapid postoperative improvement, patient’s regular follow-up remains uneventful. A subperiosteal orbital abscess is a severe complication of rhinosinusitis that can ultimately endanger a patient’s vision. It is most commonly located on the medial orbital wall, resulting from direct spread of infection from the ethmoid cells. The rather uncommon superiorly based subperiosteal abscess occurs superiorly to the frontoethmoidal suture line, with frontal sinusitis being its main cause. Treating it solely endoscopically is more challenging than in medial wall abscesses, and a combined approach is often necessary.

  • ear
  • nose and throat
  • infections
  • nose and throat/otolaryngology
  • otolaryngology / ENT

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Footnotes

  • Contributors GC reviewed the case and the literature and wrote the first draft. PK reviewed and edited the draft and figures. EK reviewed the manuscript and provided supervision. AC was the attending surgeon and reviewed and edited the final manuscript. The final manuscript was approved by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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