Orbital Cellulitis: Medical and Surgical Management
|Nicholas J. Potter1*, Christopher L. Brown2, Alan A. McNab2 and Simon Y. Ting3|
|1Eastern Health, Department of Otolaryngology, Head and Neck Surgery, Eastern Health, Box Hill Hospital, Australia|
|2The Royal Victorian Eye and Ear Hospital, Melbourne Victoria, Australia|
|3Princess Alexandria Hospital, Brisbane, Queensland, Australia|
|Corresponding Author :||Nicholas J Potter
Department of Otolaryngology
Head and Neck Surgery, Eastern Health, Box Hill Hospital
Nelson Rd, Box Hill, VIC 3165, Australia
Tel: (03) 9895 3333
Fax: (03) 9895 3176
E-mail: [email protected]
|Received August 13, 2011; Accepted September 03, 2011; Published September 28, 2011|
|Citation: Potter NJ, Brown CL, McNab AA, Ting SY (2011) Orbital Cellulitis: Medical and Surgical Management. J Clinic Experiment Ophthalmol S2:001. doi:10.4172/2155-9570.S2-001|
|Copyright: © 2011 Potter NJ, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.|
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Introduction: Orbital cellulitis is a potential sight-threatening infection of the ocular adnexal structures posterior to the orbital septum. Acute bacterial sinusitis remains the most common cause of orbital cellulitis.
Methods: A retrospective chart review was performed for patients admitted to The Royal Victorian Eye and Ear Hospital with a diagnosis of orbital cellulitis over a five-year period to July 2009.
Results: 78 patients were identified for inclusion in the study, median age 42 years. Sinusitis was the most common predisposing factor, and was present in 52 patients (67%). All patients were treated with intravenous antibiotics. Surgical drainage was required for 28 patients (36%). Of these patients, 3 underwent endoscopic drainage only, 21 underwent open drainage, and 4 patients underwent a combination of open and endoscopic drainage. The most significant complication seen was persistent decreased visual acuity despite treatment, which was present in 5 patients (6%).
Discussion: Orbital cellulitis remains a potentially sight-threatening infection that requires careful management, preferably by combined ENT and Ophthalmology teams. Surgery is reserved for those patients in whom signs of visual compromise are present initially, or in those who fail to improve with maximal medical management. Currently endoscopic drainage is not the most common surgical approach, however for selected patients it appears a safe comparable alternative.