Piazza P, Comoretto M, Lutman M
Servizio di Radiologia, USL 11, Ospedale Civile di Pordenone.
Radiol Med. 1994 Mar;87(3):235-9.
Acute orbital infection, which is usually secondary to sinusitis, requires prompt diagnosis and timely treatment to prevent the infection from spreading and to avoid severe complications, such as osteomyelitis, orbital and cerebral abscesses, meningitis and cavernous sinus thrombophlebitis. Fifteen young patients with orbital cellulitis were examined: they were 13 men and 2 women, whose mean age was 23 years, with orbital cellulitis secondary to fronto-ethmoidal sinusitis (10 cases), to maxillary sinusitis (4 cases) and to craniofacial trauma (1 case). On the basis of CT findings the patients were divided into two groups according to whether the inflammatory process involved the preseptal (4 cases) or the postseptal (11 cases) space; postseptal cellulitis was classified as orbital cellulitis and subperiosteal abscesses. The site of the inflammatory process must always be accurately located because orbital septum integrity does affect treatment choice, which in our series was medical in preseptal cellulitis and always surgical in subperiosteal abscess. After describing the CT patterns of cellulitis and its possible complications, the authors emphasize the role of CT as the method of choice to confirm clinical diagnosis and to demonstrate the site, the extent and the complications of acute orbital cellulitis.
急性眼眶感染通常继发于鼻窦炎,需要及时诊断和治疗,以防止感染扩散并避免严重并发症,如骨髓炎、眼眶和脑脓肿、脑膜炎及海绵窦血栓性静脉炎。对15例眼眶蜂窝织炎的年轻患者进行了检查:其中男性13例,女性2例,平均年龄23岁,眼眶蜂窝织炎继发于额筛窦炎(10例)、上颌窦炎(4例)和颅面外伤(1例)。根据CT表现,患者根据炎症过程是否累及眶隔前间隙(4例)或眶隔后间隙(11例)分为两组;眶隔后蜂窝织炎分为眼眶蜂窝织炎和骨膜下脓肿。必须始终准确确定炎症过程的部位,因为眶隔完整性确实会影响治疗选择,在我们的系列研究中,眶隔前蜂窝织炎采用药物治疗,骨膜下脓肿则始终采用手术治疗。在描述了蜂窝织炎的CT表现及其可能的并发症后,作者强调CT作为确诊临床诊断以及显示急性眼眶蜂窝织炎的部位、范围和并发症的首选方法的作用。