Ephraim Eviatar1, Judith Sandbank2, Stephen Kleid3, Haim Gavriel4. 1. Department of Otolaryngology Head and Neck Surgery, Assaf Harofeh Medical Center, Zerifin 70300, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. 2. Department of Pathology, Assaf Harofeh Medical Center, Zerifin 70300, Israel; Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv, Israel. 3. Department of Surgical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia. 4. Department of Surgical Oncology, Peter MacCallum Cancer Institute, Melbourne, Australia. Electronic address: haim.ga@012.net.il.
Abstract
BACKGROUND: Sub-periosteal orbital abscess (SPOA) typically presents as a collection of pus in the space between the periorbita and the lamina papyracea, adjacent to acute suppurative ethmoiditis. Osteitis of the lamina papyracea may lead to sequestrum formation, with progression of the infectious process to cause suppuration beneath the orbital periosteum. MATERIALS AND METHODS: A case series of children with rhinosinusitis and SPOA admitted to our institute, from January 2005 to December 2011, was carried out. Included were children operated upon, in whom the lamina papyracea was submitted for histological examination, and in which bacteriologic studies were obtained. RESULTS: Nine children with SPOA with a mean age of 5.03 years (range 1-12 years) were included in the present study. In five of them (55.5%), features of osteitis were noted histologically. No pathogens were observed histologically in the sections. Bacteriologic studies revealed Streptococcus viridans in four patients, and coagulase negative Staphylococcus in one. CONCLUSION: SPOA in rhinosinusitis children was associated in our small cohort with high rate of lamina papyracea osteitis. The direct spread through the involved bone was raised as a possible pathophysiology of SPOA formation.
BACKGROUND: Sub-periosteal orbital abscess (SPOA) typically presents as a collection of pus in the space between the periorbita and the lamina papyracea, adjacent to acute suppurative ethmoiditis. Osteitis of the lamina papyracea may lead to sequestrum formation, with progression of the infectious process to cause suppuration beneath the orbital periosteum. MATERIALS AND METHODS: A case series of children with rhinosinusitis and SPOA admitted to our institute, from January 2005 to December 2011, was carried out. Included were children operated upon, in whom the lamina papyracea was submitted for histological examination, and in which bacteriologic studies were obtained. RESULTS: Nine children with SPOA with a mean age of 5.03 years (range 1-12 years) were included in the present study. In five of them (55.5%), features of osteitis were noted histologically. No pathogens were observed histologically in the sections. Bacteriologic studies revealed Streptococcus viridans in four patients, and coagulase negative Staphylococcus in one. CONCLUSION: SPOA in rhinosinusitis children was associated in our small cohort with high rate of lamina papyracea osteitis. The direct spread through the involved bone was raised as a possible pathophysiology of SPOA formation.