CT pre-contrast CT coronal

Diagnosis: Periorbital cellulitis with subperiosteal abscess

Periorbital cellulitis is most commonly associated with ethmoidal sinusitis and is typically seen in the pediatric population. Usually the infection is localized to the pre-septal soft tissues and is treated by antibiotics. Occasionally infection may spread through the ethmoidal veins, which have no valves, through the lamina papyracea into the orbit resulting in an orbital cellulitis. Often the pus collects below the periosteum of the medial wall of the orbit. This is treated by surgical drainage either via external ethmoidectomy or endoscopic ethmoidectomy. Most patients are otherwise healthy although some may have cystic fibrosis or are immunocompromised. Complications include cavernous sinus thrombosis and visual loss. The most common etiologic agents are streptococcus and haemophilus. Related Cases

Harris GJ. Subperiosteal abscess of the orbit. Age as a factor in the bacteriology and response to treatment. Ophthalmology, Mar 1994; 101(3):p585-95.

Arjmand EM, Lusk RP, Muntz HR. Pediatric sinusitis and subperiosteal orbital abscess formation: diagnosis and treatment. Otolaryngology - Head & Neck Surgery, Nov 1993; 109(5):p886-94. Skedros DG, Haddad J Jr, Bluestone CD, et al. Subperiosteal orbital abscess in children: diagnosis, microbiology, and management. Laryngoscope, Jan 1993; 103(1 Pt 1):p28-32.

Nasolacrimal carcinoma Squamous cell carcinoma Periorbital cellulitis