Sciarretta Vittorio, Demattè Marco, Farneti Paolo, Fornaciari Martina, Corsini Ilaria, Piccin Ottavio, Saggese Domenico, Fernandez Ignacio Javier
Department of Otolaryngology, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Department of Pediatrics, Sant'Orsola-Malpighi Hospital, University of Bologna, Via Massarenti 9, 40138 Bologna, Italy.
Int J Pediatr Otorhinolaryngol. 2017 May;96:72-76. doi: 10.1016/j.ijporl.2017.02.031. Epub 2017 Mar 6.
Pediatric periorbital cellulitis represents a common disease complicating a nasal infection.
A ten-year retrospective review of fifty-seven children admitted to our institution with the diagnosis of periorbital cellulitis as a complication of sinus infections was carried out.
The age varied from one month to eleven years (mean 3.9 years). Thirty-five were males (62%), while twenty-two were females (38%). Nine out of fifty-seven (15.8%) presented exophthalmos associated with eyelid erythema and edema, while the rest suffered mainly from eyelid erythema and edema. Twenty-two patients complaining of exophthalmos or not responding to medical therapy within 48 h were assessed with a computed tomography scan (38.6%). A subperiosteal orbital abscess was detected in nine cases and these patients underwent surgical drainage (15,8%). Recurrence of orbital infection occurred in three cases (5.3%).
Medical management is the main treatment for both preseptal and postseptal orbital cellulitis. Nevertheless, there is no universally accepted guideline for the treatment of subperiosteal abscesses and each case should be treated accordingly. Urgent surgical drainage should be considered in cases not responding to adequate medical management, or those cases presenting visual deterioration.
小儿眶周蜂窝织炎是一种常见的鼻部感染并发症。
对我院收治的57例因鼻窦感染并发眶周蜂窝织炎的患儿进行了为期10年的回顾性研究。
年龄从1个月至11岁不等（平均3.9岁）。男性35例（62%），女性22例（38%）。57例中有9例（15.8%）出现眼球突出并伴有眼睑红斑和水肿，其余主要表现为眼睑红斑和水肿。22例主诉眼球突出或在48小时内对药物治疗无反应的患者接受了计算机断层扫描评估（38.6%）。9例检测到骨膜下眶脓肿，这些患者接受了手术引流（15.8%）。3例出现眼眶感染复发（5.3%）。
药物治疗是眶隔前和眶隔后眶周蜂窝织炎的主要治疗方法。然而，对于骨膜下脓肿的治疗尚无普遍接受的指南，应根据具体情况进行个体化治疗。对于对充分的药物治疗无反应或出现视力恶化的病例，应考虑紧急手术引流。
