Department of Otolaryngology, KK Women's and Children's Hospital, Singapore, Singapore.
Ear Nose Throat J. 2024 Sep;103(9):559-564. doi: 10.1177/01455613211064002. Epub 2022 Jan 13.
Orbital cellulitis is an uncommon condition with risks to sight and life. As a complication of maxillofacial injuries, the literature suggests this is only possible with fractures or direct inoculation, and there are no reports to the contrary. Here, we make the first report of a possible etiology by which orbital cellulitis developed in a 14-year-old boy even without skin breach or bony fractures; as well as a rare causative pathogen. He presented with facial abscess and progressive orbital cellulitis after blunt facial trauma, requiring functional endoscopic sinus surgery with needle aspiration of facial abscess externally. Cultures showed growth of , and he received further antibiotics with full recovery.The pathophysiology of orbital cellulitis in this patient is attributed to vascular congestion and local pressure from maxillofacial contusion and maxillary hemoantrum, with impaired paranasal sinus ventilation encouraging anaerobic bacterial growth. Further progression led to facial abscess formation and intraorbital spread with orbital cellulitis. The pediatric demographic is injury-prone, and self-reporting of symptoms can be delayed. Hence, increased suspicion of complicated injuries and orbital cellulitis may be required when managing maxillofacial contusions so that prompt treatment can be given.
眶蜂窝织炎是一种罕见的疾病，会对视力和生命造成威胁。作为颌面损伤的并发症，文献表明，只有在骨折或直接接种的情况下才有可能发生这种情况，而且没有相反的报道。在这里，我们首次报告了一种可能的病因，即 14 岁男孩在没有皮肤破裂或骨骨折的情况下发生眶蜂窝织炎；以及一种罕见的病原体。他因钝性面部外伤后出现面部脓肿和进行性眶蜂窝织炎，需要经功能性内窥镜鼻窦手术从外部用针抽吸面部脓肿。培养显示生长 ，并进一步使用抗生素治疗，完全康复。该患者眶蜂窝织炎的病理生理学归因于颌面挫伤和上颌窦积血引起的血管充血和局部压力，副鼻窦通气受损导致厌氧细菌生长。进一步发展导致面部脓肿形成和眶内蔓延，形成眶蜂窝织炎。儿科人群易受伤，症状的自我报告可能会延迟。因此，在处理颌面挫伤时，可能需要增加对复杂损伤和眶蜂窝织炎的怀疑，以便及时进行治疗。
