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眼眶蜂窝织炎、眶骨膜下脓肿和眶内脓肿:三例报告及文献复习

Orbital cellulitis, orbital subperiosteal and intraorbital abscess: report of three cases and review of the literature.

作者信息

Vairaktaris Eleftherios, Moschos Marilita M, Vassiliou Stavros, Baltatzis Stefanos, Kalimeras Eleftherios, Avgoustidis Dimitrios, Pappas Zisis, Moschos Michael N

机构信息

Department of Maxillofacial Surgery, University of Athens Medical School, Athens, Greece.

出版信息

J Craniomaxillofac Surg. 2009 Apr;37(3):132-6. doi: 10.1016/j.jcms.2008.10.007. Epub 2008 Dec 4.

Abstract

INTRODUCTION

Orbital cellulitis is usually a complication of paranasal sinus infection. Either the infection may dissect under the periosteum and lead to subperiosteal abscess (SPA) or intraorbital abscess may be formed secondary to a progressive and localized cellulitis. Without appropriate treatment orbital infection may lead to serious complications, even death.

REPORT OF CASES

Three cases are described, one of orbital cellulitis, one of SPA and one of intraorbital abscess and the literature is being reviewed.

CONCLUSION

Prompt treatment is mandatory to avoid visual loss or intracranial complications. Initially, IV antibiotics may be administered, but if no improvement appears within 48h, surgical drainage of the orbit and the affected sinuses must be performed. In medial or medial-inferior SPA a transnasal approach is used, but in superior orbital abscess an external incision is required.

摘要

引言

眼眶蜂窝织炎通常是鼻窦感染的并发症。感染可能在骨膜下扩散并导致骨膜下脓肿(SPA),或者进展性局部蜂窝织炎继发眶内脓肿。若未得到恰当治疗,眼眶感染可能导致严重并发症,甚至死亡。

病例报告

描述了三例病例,分别为眼眶蜂窝织炎、骨膜下脓肿和眶内脓肿各一例,并对相关文献进行了综述。

结论

必须及时治疗以避免视力丧失或颅内并发症。最初可静脉给予抗生素,但如果48小时内未见改善,则必须对眼眶和受累鼻窦进行手术引流。对于内侧或内下侧骨膜下脓肿采用经鼻入路,但眶上脓肿则需要外部切口。

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