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Annals of the Royal College of Surgeons... Jun 2022Orbital cellulitis is a condition with a high risk of morbidity, including visual loss. It commonly originates from the paranasal sinuses. We present a case of...
Orbital cellulitis is a condition with a high risk of morbidity, including visual loss. It commonly originates from the paranasal sinuses. We present a case of multifocal intraorbital abscesses secondary to viral sinusitis in an adolescent with SARS-CoV-2 infection. This patient presented with classic symptoms of orbital cellulitis, but did not display classical symptoms of COVID-19. The patient initially underwent endoscopic drainage, followed by a combined approach which yielded no pus. He recovered without complication. This is the second report of its type showing a causative link between SARS-CoV-2 and orbital cellulitis.
Topics: Abscess; Adolescent; Anti-Bacterial Agents; COVID-19; Cellulitis; Humans; Male; Orbital Cellulitis; Retrospective Studies; SARS-CoV-2
PubMed: 35196179
DOI: 10.1308/rcsann.2021.0306 -
Clinical Ophthalmology (Auckland, N.Z.) 2022To investigate the clinical characteristics of idiopathic orbital inflammation and changes in intraocular pressure (IOP) before and after its treatment.
PURPOSE
To investigate the clinical characteristics of idiopathic orbital inflammation and changes in intraocular pressure (IOP) before and after its treatment.
PATIENTS AND METHODS
We retrospectively studied 20 eyes from the medical records of 19 patients who were diagnosed with idiopathic orbital inflammation between April 1, 2004, and April 30, 2019, at Toyama University Hospital. The inflammation site (type of disease), treatment provided, IOP before and after treatment, and the symptoms (proptosis, decreased ocular movements or diplopia, periorbital edema, and ocular pain) were analyzed.
RESULTS
The types of idiopathic orbital inflammation were dacryoadenitis in 14, myositis in 7, diffuse-type in 3, and posterior periscleritis in 1 case. The mean IOP after treatment was 15.4±3.9 mm Hg, which was significantly lower than the mean pretreatment IOP of 19.0±5.3 mm Hg (p = 0.009). Before treatment, all cases with the diffuse-type had high IOPs of 21 mm Hg or more. Ocular pain and eye movement disorders were present in 86% and 100% of subjects in the group with an IOP of 21 mm Hg or higher, but 38% and 31% in the group with an IOP of 20 mm Hg or lower, respectively.
CONCLUSION
Diffuse-type of idiopathic orbital inflammation is prone to develop high IOP. Patients with idiopathic orbital inflammation and high IOP exhibit many symptoms such as decreased ocular movements, diplopia, and ocular pain.
PubMed: 35592671
DOI: 10.2147/OPTH.S361645 -
Cureus Aug 2020Periorbital ecchymosis and edema are common after septorhinoplasty surgery. This study aimed to compare internal and external lateral nasal osteotomies performed in...
OBJECTIVE
Periorbital ecchymosis and edema are common after septorhinoplasty surgery. This study aimed to compare internal and external lateral nasal osteotomies performed in septorhinoplasty in terms of postoperative ecchymosis and edema.
METHODS
Patients who underwent septorhinoplasty between January 2020 and July 2020 in our clinic were included in the study. In all patients, right lateral nasal osteotomies were performed endonasally and left lateral nasal osteotomies externally. The postoperative 1st, 7th, and 14th day ecchymosis and edema scores of all patients were calculated separately for the two groups and compared.
RESULTS
A total of 60 patients (29 females, 31 males) were included in the study. The mean age of the patients was 33.88 ± 10.30 years. No significant difference was observed between the two groups in terms of the postoperative periorbital ecchymosis scores on the first day and the first and second weeks (0.314, 0.344, and 0.468, respectively). There was also no significant difference between the two groups in terms of the postoperative periorbital edema scores on the first day and at the first and second weeks (0.272, 0.359, and 0.513, respectively).
CONCLUSION
The results obtained from this study showed no significant difference in the periorbital ecchymosis and edema scores between the patients who had undergone septorhinoplasty with internal or external lateral osteotomies. Further multicenter studies are recommended to verify the findings of this study with a larger sample size.
PubMed: 32923211
DOI: 10.7759/cureus.9609 -
Clinical Case Reports Mar 2019Orbital involvement occurs in 85% of complicated acute sinusitis and is more prevalent in children. Prompt differentiation between the more common periorbital...
Orbital involvement occurs in 85% of complicated acute sinusitis and is more prevalent in children. Prompt differentiation between the more common periorbital (preseptal) cellulitis and infections, posterior to the orbital septum (including orbital cellulitis/abscess), is essential due to the latter's risk of irreversible optic neuropathy, intracranial spread and death.
PubMed: 30899507
DOI: 10.1002/ccr3.2047 -
Indian Journal of Ophthalmology Feb 2022To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital...
Orbital magnetic resonance imaging profile and clinicoradiological correlation in COVID-19-associated rhino-orbital-cerebral mucormycosis: A single-center study of 270 patients from North India.
PURPOSE
To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform a clinicoradiological correlation.
METHODS
A cross-sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA-ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs.
RESULTS
Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter-rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (κ 0.621) and 93.70% (κ 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively.
CONCLUSION
Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.
Topics: COVID-19; Cross-Sectional Studies; Female; Humans; India; Magnetic Resonance Imaging; Male; Middle Aged; Mucormycosis; Orbital Cellulitis; Orbital Diseases; SARS-CoV-2
PubMed: 35086254
DOI: 10.4103/ijo.IJO_1652_21 -
American Journal of Ophthalmology Case... Mar 2019If not recognized and treated promptly, nontraumatic orbital subperiosteal hemorrhage (NTSOH) can have serious sequelae including compressive optic neuropathy and...
PURPOSE
If not recognized and treated promptly, nontraumatic orbital subperiosteal hemorrhage (NTSOH) can have serious sequelae including compressive optic neuropathy and permanent vision loss. The following case establishes erotic asphyxiation as a cause of NTSOH.
OBSERVATIONS
A 29 year-old patient presented with diplopia and periorbital edema and ecchymosis. Complete ophthalmologic exam showed no optic neuropathy. Computed tomography of the orbits revealed a subperiosteal fluid collection in the right orbit. The patient had no risk factors for NTSOH, but after detailed questioning she admitted to participating in erotic asphyxiation prior to the onset of her symptoms. She was observed and subsequently lost to follow up.
CONCLUSIONS AND IMPORTANCE
To the authors' knowledge, erotic asphyxiation as a cause of orbital subperiosteal hematoma has not been previously reported. Lack of knowledge about erotic asphyxiation amongst healthcare providers may contribute to hesitance to directly question patients about the practice. Clinicians should be aware of erotic asphyxiation as a potential cause of orbital subperiosteal hemorrhage.
PubMed: 30619972
DOI: 10.1016/j.ajoc.2018.12.013 -
Lin Chuang Er Bi Yan Hou Tou Jing Wai... Feb 2022The aim of this study is to explore the treatment strategy of children's nasal orbital complications. The clinical data of 28 children with nasal orbital complications...
The aim of this study is to explore the treatment strategy of children's nasal orbital complications. The clinical data of 28 children with nasal orbital complications admitted to Dalian Children's Hospital from February 2018 to February 2021 were analyzed and summarized. Among the 28 children, 18 were males (64.3%), 10 females (35.7%), 16 cases of orbital cellulitis, 10 cases of orbital subperiosteal abscess, 1 case of intraorbital abscess, and 1 case of cavernous sinus thrombophlebitis. Of the children with orbital cellulitis, 2 cases were treated with surgery, 4 cases with orbital subperiosteal abscess were treated with surgery, and the children with intraorbital abscess and cavernous sinus thrombophlebitis were treated with surgery. All the children were cured, and the clinical follow-up was more than half a year. No recurrence occurred. Periorbital cellulitis is the most common type of orbital complications. After conservative treatment (3-7 days), most children can get good results. Once the visual acuity is progressively decreased, the infection becomes worse, the eyeball movement disorder and other symptoms occur at this time, surgical treatment should be actively considered, and the timing of surgery is very important for the prognosis.
Topics: Abscess; Anti-Bacterial Agents; Child; Female; Humans; Male; Nose; Orbital Cellulitis; Orbital Diseases; Retrospective Studies
PubMed: 35172552
DOI: 10.13201/j.issn.2096-7993.2022.02.012 -
Cancer Treatment and Research... 2022
PubMed: 36463021
DOI: 10.1016/j.ctarc.2022.100654 -
Antibiotics (Basel, Switzerland) Sep 2022The delayed treatment of pediatric periorbital cellulitis may have severe consequences. In addition, the antibiotic efficacy against causative bacteria may change over...
The delayed treatment of pediatric periorbital cellulitis may have severe consequences. In addition, the antibiotic efficacy against causative bacteria may change over time, and it is important to understand the appropriate antibiotic options for effective treatment in pediatric patients. We compared the changes in cultured bacteria and drug susceptibility tests between two decades, 2010-2019 and 2000-2009, to establish antibiotics for empirical use. The patient characteristics, etiologies, culture sites, and isolated bacteria, and the antibiotic susceptibility tests of the admitted pediatric patients ( = 207) diagnosed with preseptal and orbital cellulitis during 2000 to 2019, were recorded. Insect/animal bites ( = 0.084) showed an increasing trend, and sinusitis ( = 0.016) showed a significant decrease in the past decades. The most common bacteria were , and methicillin-resistant (MRSA) infections increased in recent decades ( = 0.01). Moreover, we found that vancomycin was ideal for MRSA infections. The decreasing efficacy of oxacillin correlates with the increasing proportion of MRSA in pediatric periorbital cellulitis. Our study thus offers antibiotic choices against the most common isolates that can be administered before culture results are available.
PubMed: 36289946
DOI: 10.3390/antibiotics11101288 -
Clinical Medicine Insights. Case Reports 2024Infratemporal fossa (ITF) tumors are rare in children and may present with a variety of symptoms. Teratomas are neoplasms derived from the 3 germ layers and...
Infratemporal fossa (ITF) tumors are rare in children and may present with a variety of symptoms. Teratomas are neoplasms derived from the 3 germ layers and approximately 6% to 10% are within the head and neck. Our study discusses one of the first reported cases of teratoma in the ITF in a pediatric patient. A 3-year-old girl presents with 2 years of recurrent monthly left periorbital swelling accompanied by fevers, skin discoloration, and pain. Prior episodes were treated with antibiotics with incomplete resolution. Imaging revealed a cystic lesion centered in the ITF. She was taken for endoscopic endonasal biopsy of the lesion and had no complications. Pathology revealed a mature teratoma composed primarily of pancreatic tissue. Providers should consider masses such as teratoma in the differential for ITF tumors and periorbital edema unresponsive to typical treatment.
PubMed: 38827640
DOI: 10.1177/11795476241255563