Alabdulrazzaq Elaf S, Alajmi Mohammed N, Alsalem Ahmed S
Ophthalmology, Prince Sultan Military Medical City, Riyadh, SAU.
Cureus. 2023 Aug 21;15(8):e43843. doi: 10.7759/cureus.43843. eCollection 2023 Aug.
We present a rare case of non-medial subperiosteal abscess secondary to orbital cellulitis in a 63-year-old female. The patient reported a five-day history of progressive swelling, pain, and diminished vision in the left eye. Computed tomography (CT) of the orbit revealed an extraconal soft tissue density, suggestive of an orbital collection, which when correlated clinically and radiologically, was diagnosed as orbital cellulitis secondary to sinusitis, leading to a subperiosteal abscess. Despite undergoing multiple external drainage procedures, the patient, unfortunately, experienced complete vision loss in the affected eye. While non-medial abscesses due to orbital cellulitis are infrequent, they are often associated with more severe outcomes, including vision loss and intracranial complications, compared to those in medial locations. This case underscores the importance of combined surgical approaches, including both sinus and external drainage, to prevent severe vision loss and potentially life-threatening intracranial sequelae.
我们报告了一例罕见的非内侧骨膜下脓肿病例，该病例继发于一名63岁女性的眼眶蜂窝织炎。患者自述左眼渐进性肿胀、疼痛和视力下降已有五天病史。眼眶计算机断层扫描（CT）显示眶锥外软组织密度，提示眼眶有积液，经临床和放射学综合判断，诊断为鼻窦炎继发眼眶蜂窝织炎，进而导致骨膜下脓肿。尽管患者接受了多次外部引流手术，但不幸的是，患眼仍完全失明。与内侧部位的眼眶蜂窝织炎相比，非内侧眼眶蜂窝织炎引起的脓肿虽不常见，但往往与更严重的后果相关，包括视力丧失和颅内并发症。该病例强调了联合手术方法（包括鼻窦和外部引流）对于预防严重视力丧失和潜在危及生命的颅内后遗症的重要性。
