ENTtoday
  • Home
  • Practice Focus
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Departments
    • Issue Archive
    • TRIO Best Practices
      • Allergy
      • Facial Plastic/Reconstructive
      • Head and Neck
      • Laryngology
      • Otology/Neurotology
      • Pediatric
      • Rhinology
      • Sleep Medicine
    • Career Development
    • Case of the Month
    • Everyday Ethics
    • Health Policy
    • Legal Matters
    • Letter From the Editor
    • Medical Education
    • Online Exclusives
    • Practice Management
    • Resident Focus
    • Rx: Wellness
    • Special Reports
    • Tech Talk
    • Viewpoint
    • What’s Your O.R. Playlist?
  • Literature Reviews
    • Allergy
    • Facial Plastic/Reconstructive
    • Head and Neck
    • Laryngology
    • Otology/Neurotology
    • Pediatric
    • Rhinology
    • Sleep Medicine
  • Multimedia
    • Video
    • Audio
  • Events
    • Featured Events
    • TRIO Meetings
  • Contact Us
    • About Us
    • Editorial Board
    • Triological Society
    • Advertising Staff
    • Subscribe
  • Advertise
    • Place an Ad
    • Classifieds
    • Rate Card
  • Search

Medical Versus Surgical Management of Pediatric Orbital Subperiosteal Abscesses

by Joshua R. Bedwell, MD, and Sukgi S. Choi, MD • March 1, 2014

  • Tweet
  • Email
Print-Friendly Version

You Might Also Like

  • Myringotomy and Mastoidectomy Have Highest Cure Rates for Pediatric Acute Mastoiditis
  • Does Balloon Catheter Sinuplasty Have a Role in the Surgical Management of Pediatric Sinus Disease?
  • When Is Immediate Surgical Intervention Required for Isolated Orbital Blowout Fractures?
  • Surgical Therapy for Pediatric Patients with NTM Head and Neck Lesions Carries High Risk
Explore This Issue
March 2014

Background

Orbital subperiosteal abscess (SPA) describes a process in which a collection of pus forms between the bony orbit and the periorbita. SPA most commonly arises as a complication of acute sinusitis, where it exists along a spectrum of orbital involvement from limited (preseptal cellulitis) to severe (cavernous sinus thrombosis). The surgical management of SPA in children has evolved from drainage via an external approach to an endoscopic approach. Controversy remains, however, in deciding which SPAs require drainage, and which may be managed conservatively with systemic antibiotics.

Best Practice

Taken as a whole, the literature suggests that orbital SPA in children is not an absolute indication for immediate surgical intervention. Patients presenting with advanced ophthalmologic findings (impaired visual acuity, elevated IOP, ophthalmoplegia, proptosis ≥5 mm) or with large abscesses (width >10 mm) are best treated surgically. Patients with a less serious presentation may improve with conservative management (intravenous antibiotics, nasal saline lavage, topical decongestants). There is evidence that older patients are less likely to be adequately treated with medications alone; however, age should not be a contraindication to a trial of conservative management. All patients must be monitored closely with serial ophthalmologic examinations, and any deterioration should lead to timely drainage. Failure to improve after 48 hours likely reflects treatment failure and should prompt consideration for surgical intervention. Read the full article in The Laryngoscope.

Filed Under: Pediatric, Practice Focus, Rhinology, TRIO Best Practices Tagged With: pediatrics, SinusitisIssue: March 2014

You Might Also Like:

  • Myringotomy and Mastoidectomy Have Highest Cure Rates for Pediatric Acute Mastoiditis
  • Does Balloon Catheter Sinuplasty Have a Role in the Surgical Management of Pediatric Sinus Disease?
  • When Is Immediate Surgical Intervention Required for Isolated Orbital Blowout Fractures?
  • Surgical Therapy for Pediatric Patients with NTM Head and Neck Lesions Carries High Risk

The Triological SocietyENTtoday is a publication of The Triological Society.

The Laryngoscope
Ensure you have all the latest research at your fingertips; Subscribe to The Laryngoscope today!

Laryngoscope Investigative Otolaryngology
Open access journal in otolaryngology – head and neck surgery is currently accepting submissions.

Classifieds

View the classified ads »

TRIO Best Practices

View the TRIO Best Practices »

Top Articles for Residents

  • Do Training Programs Give Otolaryngology Residents the Necessary Tools to Do Productive Research?
  • Why More MDs, Medical Residents Are Choosing to Pursue Additional Academic Degrees
  • What Physicians Need to Know about Investing Before Hiring a Financial Advisor
  • Tips to Help You Regain Your Sense of Self
  • Should USMLE Step 1 Change from Numeric Score to Pass/Fail?
  • Popular this Week
  • Most Popular
  • Most Recent
    • The Dramatic Rise in Tongue Tie and Lip Tie Treatment
    • Vertigo in the Elderly: What Does It Mean?
    • Is There a Crisis in the Otolaryngology Match?
    • Experts Delve into Treatment Options for Laryngopharyngeal Reflux
    • New Developments in the Management of Eustachian Tube Dysfunction
    • New Developments in the Management of Eustachian Tube Dysfunction
    • Vertigo in the Elderly: What Does It Mean?
    • Eustachian Tuboplasty: A Potential New Option for Chronic Tube Dysfunction and Patulous Disease
    • Some Laryngopharyngeal Reflux Resists PPI Treatment
    • Post-Tonsillectomy Taste Disorders Rare but Present
    • 10 Novel Ways to Disseminate Scientific Information
    • How to Work with Sales and Marketing Representatives in Your Medical Practice
    • How Medicine Helped Surgeon Prepare for Career as Writer
    • Best Practices for Emergency Surgical Airway
    • Spare Roof Technique Can Improve Patient Quality of Life after Rhinoplasty

Polls

Will registry information and data science improve patient care?

View Results

Loading ... Loading ...
  • Polls Archive
  • Home
  • Contact Us
  • Advertise
  • Privacy Policy
  • Terms of Use

Visit: The Triological Society • The Laryngoscope • Laryngoscope Investigative Otolaryngology

Wiley
© 2019 The Triological Society. All Rights Reserved.
ISSN 1559-4939

loading Cancel
Post was not sent - check your email addresses!
Email check failed, please try again
Sorry, your blog cannot share posts by email.
This site uses cookies: Find out more.