.: ORİJİNAL ARAŞTIRMA
Medical and Surgical Treatment in Cases of Subperiosteal Orbital Abscess: Retrospective Descriptive Study
Subperiosteal Orbital Apse Olgularında Medikal ve Cerrahi Tedavi: Retrospektif Tanımlayıcı Araştırma
Turkiye Klinikleri J Ophthalmol. 2024;33(1):36-45
doi: 10.5336/ophthal.2023-100192
Makale Dili: EN
Tam Metin
ABSTRACT
Objective: We aimed to characterize the demographic characteristics of patients presenting with subperiosteal orbital abscess (SPOA) and determine their outcomes according to the type of medical and/or surgical interventions applied. Material and Methods: The data were retrospectively examined for all patient applications who applied to the oculoplastic surgery clinic due to SPOA and were treated as inpatients from November 2021 to October 2023. Demographic information of the patients, radiographic and clinical evidence of SPOA, surgical interventions performed, presence of concomitant sinusitis and length of hospital stay were recorded. Results: The average age of 19 SPOA patients included in the study was 18.42±20.21 years. Twelve (63.2%) of the patients with SPOA had pansinusitis. The location of the SPOA was medial in 9 patients (47.4%), superolateral in 5 patients (21.1%), and superomedial in 4 patients (21.1%). In statistical comparison, the medial SPOA rate was significantly higher in the group under 10 years of age than in the group over 10 years of age (p=0.005). Endoscopic sinus surgery (ESS) was applied to 15(78.9%) of the patients and medical treatment was applied to 4 (21.1%). External SPOA drainage was performed simultaneously with ESS in 6 (31.6%) patients with superolaterally located SPOA. Intracranial abscess developed in 2 (22.2%) of the patients with SPOA with a superior component. Conclusion: Patients with medial, small-volume SPOA can be successfully treated with a conservative approach. While medially located large volume SPOA requires ESS with ESS alone, superiolaterally located SPOA requires external surgical abscess drainage in addition to ESS.
Keywords: Acute sinusitis; endoscopic sinus surgery; subperiosteal orbital abscess; intracranial abscess
Objective: We aimed to characterize the demographic characteristics of patients presenting with subperiosteal orbital abscess (SPOA) and determine their outcomes according to the type of medical and/or surgical interventions applied. Material and Methods: The data were retrospectively examined for all patient applications who applied to the oculoplastic surgery clinic due to SPOA and were treated as inpatients from November 2021 to October 2023. Demographic information of the patients, radiographic and clinical evidence of SPOA, surgical interventions performed, presence of concomitant sinusitis and length of hospital stay were recorded. Results: The average age of 19 SPOA patients included in the study was 18.42±20.21 years. Twelve (63.2%) of the patients with SPOA had pansinusitis. The location of the SPOA was medial in 9 patients (47.4%), superolateral in 5 patients (21.1%), and superomedial in 4 patients (21.1%). In statistical comparison, the medial SPOA rate was significantly higher in the group under 10 years of age than in the group over 10 years of age (p=0.005). Endoscopic sinus surgery (ESS) was applied to 15(78.9%) of the patients and medical treatment was applied to 4 (21.1%). External SPOA drainage was performed simultaneously with ESS in 6 (31.6%) patients with superolaterally located SPOA. Intracranial abscess developed in 2 (22.2%) of the patients with SPOA with a superior component. Conclusion: Patients with medial, small-volume SPOA can be successfully treated with a conservative approach. While medially located large volume SPOA requires ESS with ESS alone, superiolaterally located SPOA requires external surgical abscess drainage in addition to ESS.
Keywords: Acute sinusitis; endoscopic sinus surgery; subperiosteal orbital abscess; intracranial abscess
ÖZET
Amaç: Subperiosteal orbital apse (SPOA) ile prezente olan hastaların demografik özelliklerini karakterize etmeyi ve uygulanan medikal ve/veya cerrahi müdahalelerin türüne göre sonuçlarını belirlemeyi amaçladık. Gereç ve Yöntemler: Veriler, Kasım 2021 yılından Ekim 2023 yılına kadar SPOA nedeniyle oküloplastik cerrahi kliniğine başvuran ve yatarak tedavi edilen tüm hasta başvuruları retrospektif olarak incelendi. Hastaların demografik bilgileri, SPOA radyografik ve klinik kanıtları, yapılan müdahaleler (cerrahi ve medikal), eş zamanlı sinüzit varlığı ve hastaneye yatış süresi kaydedildi. Bulgular: Çalışmaya dâhil edilen 19 SPOA'lı hastasının yaş ortalaması 18,42±20,21 yıldı. SPOA'lı hastaların 12'sinde (%63,2) pansinüzit vardı. SPOA'ların yerleşimi hastaların 9'unda (%47,4) mediyalde, 5'inde (%21,1) süperolateralde, 4'ünde (%21,1) süperomediyaldeydi. İstatistiksel karşılaştırmada mediyal SPOA oranı 10 yaş altı grupta 10 yaş üstü gruba göre anlamlı derecede daha yüksekti (p=0,005). Hastaların 15'ine (%78,9) endoskopik sinüs drenajı, 4'üne (%21,1) medikal tedavi uygulanmıştı. Süperolateral yerleşimli SPOA olan 6 (%31,6) hastaya endoskopik sinüs drenajı ile eş zamanlı eksternal (transkutanöz) SPOA drenajı uygulandı. Superior kompanenti olan SPOA'lı 2 (%22,2) hastada intrakraniyal apse gelişmişti. Sonuç: SPOA mediyal yerleşimli ve küçük hacimli ise konservatif yaklaşımla başarılı bir şekilde tedavi edilebilir. SPOA mediyal yerleşimli ve büyük hacimli ise endoskopik sinüs drenajı ile endoskopik apse drenajı yeterli olurken, superiolateral lokasyonlu SPOA, endoskopik sinüs drenajına ilave eksternal cerrahi apse drenajını gerektirmektedir.
Anahtar Kelimeler: Akut sinüzit; endoskopik sinüs cerrahisi; subperiosteal orbital apse; intrakraniyal apse
Amaç: Subperiosteal orbital apse (SPOA) ile prezente olan hastaların demografik özelliklerini karakterize etmeyi ve uygulanan medikal ve/veya cerrahi müdahalelerin türüne göre sonuçlarını belirlemeyi amaçladık. Gereç ve Yöntemler: Veriler, Kasım 2021 yılından Ekim 2023 yılına kadar SPOA nedeniyle oküloplastik cerrahi kliniğine başvuran ve yatarak tedavi edilen tüm hasta başvuruları retrospektif olarak incelendi. Hastaların demografik bilgileri, SPOA radyografik ve klinik kanıtları, yapılan müdahaleler (cerrahi ve medikal), eş zamanlı sinüzit varlığı ve hastaneye yatış süresi kaydedildi. Bulgular: Çalışmaya dâhil edilen 19 SPOA'lı hastasının yaş ortalaması 18,42±20,21 yıldı. SPOA'lı hastaların 12'sinde (%63,2) pansinüzit vardı. SPOA'ların yerleşimi hastaların 9'unda (%47,4) mediyalde, 5'inde (%21,1) süperolateralde, 4'ünde (%21,1) süperomediyaldeydi. İstatistiksel karşılaştırmada mediyal SPOA oranı 10 yaş altı grupta 10 yaş üstü gruba göre anlamlı derecede daha yüksekti (p=0,005). Hastaların 15'ine (%78,9) endoskopik sinüs drenajı, 4'üne (%21,1) medikal tedavi uygulanmıştı. Süperolateral yerleşimli SPOA olan 6 (%31,6) hastaya endoskopik sinüs drenajı ile eş zamanlı eksternal (transkutanöz) SPOA drenajı uygulandı. Superior kompanenti olan SPOA'lı 2 (%22,2) hastada intrakraniyal apse gelişmişti. Sonuç: SPOA mediyal yerleşimli ve küçük hacimli ise konservatif yaklaşımla başarılı bir şekilde tedavi edilebilir. SPOA mediyal yerleşimli ve büyük hacimli ise endoskopik sinüs drenajı ile endoskopik apse drenajı yeterli olurken, superiolateral lokasyonlu SPOA, endoskopik sinüs drenajına ilave eksternal cerrahi apse drenajını gerektirmektedir.
Anahtar Kelimeler: Akut sinüzit; endoskopik sinüs cerrahisi; subperiosteal orbital apse; intrakraniyal apse
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