Subperiosteal abscess of the orbit

Case contributed by Shervin Sharifkashani
Diagnosis certain

Presentation

Left side proptosis and eye adduction limitation with a history of sinusitis and runny nose.

Patient Data

Age: 5 years
Gender: Female

Subperiosteal collection thickness up to 5 mm and AP length up to 20 mm in nasal extraconal of the left orbital cavity with impression on related medial rectus muscle, the muscle swelling, left side proptosis, right eye exodeviation and preseptal and lacrimal gland soft tissue swelling are seen. Fluid and thick mucosa in all paranasal sinuses with sinus cavities obliteration are noted. A thick adenoid in the nasopharynx is also seen.

Case Discussion

The case illustrates non-contrast MDCT features of pus aspiration-proved subperiosteal abscess of the orbit and pansinusitis more commonly as a major complication of ethmoid sinusitis in children. The abscess is an ophthalmology emergency and can lead to proptosis, eye movement limitation, and in case of improper management septicemia.

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