The surgical treatment of the subperiosteal abscess of the low orbital wall of the odontogenic origin
ABSTRACT Purpose. Optimization of surgical treatment of the odontogenic subperiosteal abscess (SPA) of the inferior orbital wall. Material and methods. Within the period between 2000 and 2011 the odontogenic SPA of the low orbital wall was diagnosed in 12 patients aged from 13 to 64 (...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | Russian |
| Published: |
Publishing house "Ophthalmology"
2013-01-01
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| Series: | Офтальмохирургия |
| Subjects: | |
| Online Access: | http://www.eyepress.ru/article.aspx?11571 |
| Summary: | ABSTRACT
Purpose. Optimization of surgical treatment of the odontogenic subperiosteal abscess (SPA) of the inferior orbital wall.
Material and methods. Within the period between 2000 and 2011 the odontogenic SPA of the low orbital wall was diagnosed in 12 patients aged from 13 to 64 (mean 35.6±9.8): male 6, female 5, children 1. There were applied in the diagnosis the multi-spiral computer tomography, the magnetic resonance angiography of orbit, paranasal sinuses, brain and were found: an exudative detachment of periosteum, destruction of the low bone wall of orbit, exudate in the paranasal sinuses, thrombophlebitis of orbital veins.
Results. The SPA sources were purulent periodontitis, extraction of tooth with a fistula formation into maxillary sinus, sinusitis. Infection of the odontogenic origin penetrated into orbit by contact and hematogenic ways simultaneously with the development of the SPA, thrombophlebitis of orbital veins, pterygopalatine fossa (5), thrombosis of cavernous sinus (4), sepsis (E.coli, St.aureus).
Ten (83.3%) out of 12 patients with the odontogenic SPA associated with antibiotic therapy underwent a simultaneous subperiosteal and supraperiosteal orbitotomy by transcutaneous approach along ciliary border of inferior eyelid (the patent for invention № 2370247 of 20.10.2009). At the same time maxillaryethmoidotomia, operative exploration of maxilla, drainage of pterygopalatine fossa were performed by a otorhinolaryngologist maxillofacial surgeon. It was made in 2 patients a wrong admission diagnosis — orbital phlegmon, that led to inadequate treatment, reoperations.
Conclusion. The innovated operation turned to be highly effective in 90% of patients, allowed to exclude repeated surgical operations, to achieve a clinical recovery within 12-18 days with a good cosmetic effect maintaining visual functions. A lethal outcome was observed in one case in the patient with brain abscess who was hospitalized too late |
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| ISSN: | 0235-4160 0235-4160 |