van der Poel N A, van der Veer E G, Ebbens F A, de Win M M, Kloos R J, Mourits M P
Academisch Medisch Centrum, Amsterdam.
Ned Tijdschr Geneeskd. 2017;161:D1342.
Orbital cellulitis is a rare disease usually caused by sinusitis. Generally, the prognosis of both preseptal cellulitis and orbital cellulitis is favourable. Radiological distinction should be made between an orbital abscess and subperiosteal empyema. Theoretically, empyema is more accessible to antibiotics and, as it arises in a pre-existing anatomical space, it needs less aggressive treatment than an abscess. In contrast, the wall of an abscess created by the bacteria is scarcely permeable to antibiotics. Indications for surgical drainage should be based on clinical findings and not on Chandler's classification. Loss of vision, an unresponsive pupil or a densely packed orbit are indications for immediate surgical drainage. Drainage of an orbital abscess may speed up recovery.
眶蜂窝织炎是一种罕见疾病，通常由鼻窦炎引起。一般来说，睑前蜂窝织炎和眶蜂窝织炎的预后都较好。应通过影像学检查区分眶脓肿和骨膜下脓胸。理论上，脓胸对抗生素更敏感，而且由于它发生在已有的解剖间隙中，与脓肿相比，所需的治疗手段没那么激进。相比之下，细菌形成的脓肿壁对抗生素几乎不可渗透。手术引流的指征应基于临床检查结果，而非钱德勒分类法。视力丧失、瞳孔无反应或眼眶严重充血是立即进行手术引流的指征。眶脓肿引流可加快康复。
