A Case of Acute Orbital Abscess following Repair of Orbital wall Fracture with Alloplastic Implant

2007 ◽  
Vol 48 (12) ◽  
pp. 1706 ◽  
Author(s):  
Sang Moon Jeong ◽  
Jae Seok Yim ◽  
Do Hoon Park ◽  
Ju Yeong Kwak
Keyword(s):  
Orbital Abscess ◽  
Orbital Wall

Orbital abscess due to infection of a non-absorbable porous orbital implant after orbital wall fracture repair : An uncommon and delayed occurred case

2021 ◽  
pp. 112067212110080
Author(s):  
Moon Young Choi ◽  
Tae Yoon La
Keyword(s):  
Imaging Study ◽  
Orbital Cellulitis ◽  
Fracture Repair ◽  
Orbital Fracture ◽  
Abscess Drainage ◽  
Orbital Implant ◽  
Orbital Abscess ◽  
Orbital Wall ◽  
The Right ◽  
Considerable Period

We report a rare case of a patient who developed an orbital abscess several years after successful orbital medial wall fracture repair. A 37-year-old female patient who underwent orbital fracture repair with a titanium Medpor® orbital implant two years prior visited the clinic for pain, conjunctival injection, discharge, and lid swelling of the right eye. Orbital CT revealed severe orbital cellulitis and sinusitis. After administering antibiotics, the sinusitis was successfully resolved. However, the orbital inflammation around the implant did not improve, forming an orbital abscess. Abscess drainage and implant removal were performed. The removed implant was infected at the center, exhibiting a yellowish abscess-like discoloration. The patient improved rapidly and recovered without complications. In rare cases, orbital cellulitis and orbital abscesses develop even after a considerable period of time after orbital fracture repair using a non-absorbable porous orbital implant. In such cases, delayed orbital implant infection should be suspected as the cause, and an imaging study should be performed. If the patient does not respond to antibiotic treatment, it may be necessary to remove the infected implant with immediate drainage.

Superiorly based subperiosteal orbital abscess: an uncommon presentation

2021 ◽  
Vol 14 (2) ◽  
pp. e239861
Author(s):  
Georgios Chrysovitsiotis ◽  
Paraskevi Kollia ◽  
Efthymios Kyrodimos ◽  
Aristeidis Chrysovergis
Keyword(s):  
Suture Line ◽  
Purulent Discharge ◽  
Subperiosteal Abscess ◽  
Orbital Abscess ◽  
Ocular Manifestations ◽  
Uncommon Presentation ◽  
Orbital Wall ◽  
The Right ◽  
Medial Orbital Wall ◽  
Subperiosteal Orbital Abscess

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.

Resources: Internet Resources for the Independent Medical Evaluator – 2007

2007 ◽  
Vol 12 (4) ◽  
pp. 4-7
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker
Keyword(s):  
Head Trauma ◽  
Clonic Seizure ◽  
Acute Subdural Hematoma ◽  
Orbital Fracture ◽  
Orbital Wall ◽  
First Occurrence ◽  
One Year ◽  
The One ◽  
Neurological Injuries ◽  
Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

Outer Table Frontal Bone Fracture: When Need Surgical Intervention?

2018 ◽  
Vol 2 (3) ◽  
pp. 167
Author(s):  
Adam Mohamad ◽  
Irfan Mohamad ◽  
Khairulzaman Adnan ◽  
Syed Yusoff Alzawawi Syed Abdul Fattah
Keyword(s):  
Bone Fracture ◽  
Open Reduction ◽  
Surgical Intervention ◽  
Rectus Muscle ◽  
Frontal Bone ◽  
Facial Bone ◽  
Orbital Roof ◽  
Orbital Wall ◽  
Outer Table ◽  
Superior Rectus Muscle

Frontal bone fracture is a common facial bone fracture which commonly involved the outer table part. Most of the time outer table fracture is treated conservatively. However, when there is involvement of orbital wall fracture, as well as entrapment of extraocular muscle, surgical intervention via open reduction and internal fixation is needed. We described a case of outer table frontal bone fracture with left orbital roof fracture complicated with superior rectus muscle entrapment which was successfully treated via open reduction and internal fixation.International Journal of Human and Health Sciences Vol. 02 No. 03 July’18. Page : 167-169

Costal tubercular osteomyelitis presenting as an orbital abscess

Orbit ◽  
2020 ◽  
pp. 1-4
Author(s):  
Monalisha Pattnaik ◽  
Devjyoti Tripathy
Keyword(s):  
Orbital Abscess

scholarly journals Ethnic variation in medial orbital wall anatomy and its implications for decompression surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minhui Amy Chan ◽  
Farah Ibrahim ◽  
Arjunan Kumaran ◽  
Kailing Yong ◽  
Anita Sook Yee Chan ◽  
...  
Keyword(s):  
Relative Position ◽  
Ethmoid Sinus ◽  
Decompression Surgery ◽  
Ethnic Variation ◽  
Sinus Wall ◽  
Orbital Wall ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
Medial Orbital Wall

Abstract Background To describe the inter-ethnic variation in medial orbital wall anatomy between Chinese, Malay, Indian and Caucasian subjects. Methods Single-centre, retrospective, Computed Tomography (CT)-based observational study. 20 subjects of each ethnicity, were matched for gender and laterality. We excluded subjects younger than 16 years and those with orbital pathology. OsiriX version 8.5.1 (Pixmeo., Switzerland) and DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) were used to measure the ethmoidal sinus length, width and volume, medial orbital wall and floor angle and the relative position of the posterior ethmoid sinus to the posterior maxillary wall. Statistical analyses were performed using Statistical Package for Social Sciences version 25.0 (IBM, USA). Results There were 12 males (60 %) in each group, with no significant difference in age (p = 0.334–0.994). The mean ethmoid sinus length in Chinese, Malay, Indian and Caucasian subjects, using the Chinese as reference, were 37.2, 36.9, 38.0 and 37.4mm, the mean width was 11.6, 10.5, 11.4 and 10.0mm (p = 0.020) and the mean ethmoid sinus volume were 3362, 3652, 3349 and 3898mm3 respectively. The mean medial orbital wall and floor angle was 135.0, 131.4, 131.0 and 136.8 degrees and the mean relative position of posterior ethmoid sinus to posterior maxillary wall were − 2.0, -0.2, -1.5 and 1.6mm (p = 0.003) respectively. Conclusions No inter-ethnic variation was found in decompressible ethmoid sinus volume. Caucasians had their posterior maxillary sinus wall anterior to their posterior ethmoidal walls unlike the Chinese, Malay and Indians. Awareness of ethnic variation is essential for safe orbital decompression.

scholarly journals Unusual cause of acute sinusitis and orbital abscess in COVID-19 positive patient: Case report

2021 ◽  
Vol 79 ◽  
pp. 164-168 ◽  
Author(s):  
Courtney Brooke Shires ◽  
Theodore Klug ◽  
Stephen Dryden ◽  
Joshua Ford
Keyword(s):  
Case Report ◽  
Acute Sinusitis ◽  
Positive Patient ◽  
Patient Case ◽  
Orbital Abscess

scholarly journals Delayed unilateral pneumocephalus after bilateral endoscopic dacryocystorhinostomy in an elderly patient

2021 ◽  
Vol 14 (5) ◽  
pp. e241540
Author(s):  
Jaekyoung Lee ◽  
Dong Cheol Lee
Keyword(s):  
Elderly Patient ◽  
Cerebrospinal Fluid ◽  
Gold Standard ◽  
Standard Treatment ◽  
Nasolacrimal Duct ◽  
Intravenous Antibiotic ◽  
Duct Obstruction ◽  
Orbital Wall ◽  
Silicone Intubation ◽  
Endoscopic Dcr

Dacryocystorhinostomy (DCR) is the ‘gold standard’ treatment for nasolacrimal duct obstruction (NLDO). However, despite its recent technical advancements, complications are possible. Herein, to the best of our knowledge, we present the first reported case of delayed unilateral pneumocephalus after bilateral endoscopic DCR. An 85-year-old man with bilateral NLDO underwent endoscopic DCR with silicone intubation. After 1 month, he became lethargic and was admitted to emergency room. Brain CT demonstrated left pneumocephalus and a suspected microfistula in left orbital wall. Intravenous antibiotic therapy was started, and cerebrospinal fluid studies showed no evidence of meningitis. After 13 days of antibiotic treatment, his mental state recovered with no signs of pneumocephalus. Although DCR has high success rate and is relatively safe, surgeons should be aware of the risk, although low, of pneumocephalus, especially in elderly patients who are vulnerable to fractures and who exhibit headache or mental status changes after endoscopic DCR.

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