Tumuluri Vinay, Tong Jessica Y, Tumuluri Krishna, Selva Dinesh
Faculty of Health and Medical Sciences, School of Dentistry, University of Adelaide, Adelaide, Australia.
Department of Ophthalmology & Visual Sciences, University of Adelaide, North Terrace, 5000, Adelaide, South Australia, Australia.
J Ophthalmic Inflamm Infect. 2024 Oct 1;14(1):48. doi: 10.1186/s12348-024-00422-0.
To assess the radiological features and clinical outcomes of odontogenic orbital cellulitis.
Multi-centre retrospective study of odontogenic orbital cellulitis. Primary outcomes assessed were causal organism(s), clinical signs, radiological findings, management and visual outcomes.
Four patients with odontogenic orbital cellulitis were identified for inclusion. There was an equal proportion of men and women with a mean age of 43 years (range 25-56 years). All patients presented with an orbital compartment syndrome, with visual acuity of counting fingers (n = 1, 25%), hand movements (n = 1, 25%) and no perception of light (n = 2, 50%). The organisms implicated were Streptococcus milleri (n = 3, 75%) and Streptococcus constellatus (n = 1, 25%). MRI findings showed a subperiosteal abscess was present in all cases, which was characterised radiologically as a T1-hyperintense, T2 minimally hyperintense collection with restricted diffusion and a low apparent diffusion coefficient signal. Final visual acuity ranged from 6/6 to no light perception. One patient required an orbital exenteration due to extensive necrosis with sepsis and systemic deterioration.
Odontogenic orbital cellulitis carries a serious risk of vision loss with a propensity to present with an orbital compartment syndrome secondary to Streptococcus species. Outcomes were highly variable, with two cases progressing to blindness of which one required an orbital exenteration.
评估牙源性眶蜂窝织炎的影像学特征及临床结局。
对牙源性眶蜂窝织炎进行多中心回顾性研究。评估的主要结局包括致病微生物、临床体征、影像学表现、治疗及视力结局。
确定纳入4例牙源性眶蜂窝织炎患者。男女比例相等，平均年龄43岁（范围25 - 56岁）。所有患者均出现眶间隔综合征，视力分别为指数（n = 1，25%）、手动（n = 1，25%）和无光感（n = 2，50%）。涉及的微生物为米勒链球菌（n = 3，75%）和星座链球菌（n = 1，25%）。MRI表现显示所有病例均存在骨膜下脓肿，其影像学特征为T1高信号、T2轻度高信号，弥散受限，表观扩散系数信号低。最终视力范围从6/6到无光感。1例患者因广泛坏死伴脓毒症和全身状况恶化而需要进行眶内容摘除术。
牙源性眶蜂窝织炎存在严重的视力丧失风险，倾向于继发链球菌属感染而出现眶间隔综合征。结局差异很大，2例进展为失明，其中1例需要进行眶内容摘除术。
