Luthra Shreya, Kossler Andrea L, Erickson Benjamin P, Homer Natalie A
Faculty of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, Canada.
Division of Ophthalmic Plastic and Reconstructive Surgery, Department of Ophthalmology, Byers Eye Institute, Stanford University, Palo Alto, CA 94303, USA.
J Clin Med. 2024 Nov 21;13(23):7011. doi: 10.3390/jcm13237011.
: This study aims to compare the surgical outcomes of transorbital versus endonasal endoscopic approaches for orbital subperiosteal abscess drainage. : A retrospective review was conducted at a single institution of patients who underwent orbital subperiosteal abscess drainage from November 2009 to April 2023. : Of 64 patients, 44 (68.8%) underwent abscess drainage via an orbital approach, while 20 (31.3%) underwent endonasal endoscopic drainage. No significant difference in operative time or visual acuity improvement was found between the two groups. Abscess drainage via orbitotomy was associated with a longer total (average 8.1 days) and postoperative (average 7.3 days) hospitalization time compared to the endoscopic group (average 5.4 days and 4.2 days, respectively), though this difference was not statistically significant ( = 0.197, 0.136, respectively). For medial orbital abscesses, the average length of total and postoperative hospitalization was greater after orbitotomy ( = 0.028 and 0.019, respectively). At discharge, patients who underwent orbitotomy more commonly reported periorbital swelling ( = 0.0003), while postoperative pain was more common in the endoscopic drainage group ( = 0.009). Reoperation rate was higher after orbitotomy (34.1%) compared to the endoscopic drainage group (15.0%), though this was not statistically significant ( = 0.115). : Transorbital and endoscopic surgical approaches for orbital abscess drainage have similar surgical outcomes, with no statistically significant differences noted in terms of visual acuity change or reoperation rate. Longer hospital stays were found for patients with medial orbital abscesses drained via orbitotomy.
本研究旨在比较经眶入路与鼻内镜入路进行眶骨膜下脓肿引流的手术效果。在一家机构对2009年11月至2023年4月期间接受眶骨膜下脓肿引流的患者进行了回顾性研究。64例患者中，44例（68.8%）通过眶入路进行脓肿引流，20例（31.3%）接受鼻内镜引流。两组在手术时间或视力改善方面未发现显著差异。与内镜组（分别为平均5.4天和4.2天）相比，经眶切开引流脓肿的患者总住院时间（平均8.1天）和术后住院时间（平均7.3天）更长，尽管这种差异无统计学意义（分别为 = 0.197和0.136）。对于眶内侧脓肿，经眶切开术后总住院时间和术后住院时间的平均长度更长（分别为 = 0.028和0.019）。出院时，经眶切开术的患者更常报告眶周肿胀（ = 0.0003），而术后疼痛在内镜引流组更常见（ = 0.009）。经眶切开术后的再次手术率（34.1%）高于内镜引流组（15.0%），尽管这无统计学意义（ = 0.115）。经眶和内镜手术治疗眶脓肿引流的手术效果相似，在视力变化或再次手术率方面未发现统计学上的显著差异。经眶切开术引流眶内侧脓肿的患者住院时间更长。
