Facial trauma aggravating paediatric orbital cellulitis

Abstract

We describe a case of paediatric orbital cellulitis with subperiosteal abscess following blunt facial trauma. Clinical features of orbital cellulitis developed on day 1 post-trauma. A subperiosteal collection subsequently formed lateral to the globe, causing significant ocular compromise. Surgical drainage and sinus washout were performed via external incisions, with satisfactory outcome. This case highlights how trauma may represent a non-sinogenic aggravating factor in orbital cellulitis. We describe how a subperiosteal abscess may vary depending on its aetiology, and how the surgical approach can be modified to locate and drain a laterally sited subperiosteal abscess.

Keywords: ear, nose and throat/otolaryngology; ophthalmology; otolaryngology / ENT.

Figure 1

CT of the orbits with galodinium contrast on day 1 of admission, coronal view. There is gross oedema of the right eye periorbital soft tissues with a small fluid collection lateral to the orbit, as shown by the arrow.

Figure 2

CT of the orbits with galodinium contrast day 2 after the initial operation, coronal view. There is an abscess in the region of the right superior rectus muscle (as indicated by the arrow) with inferior displacement of the orbit.