Endoscopic Drainage of an Orbital Subperiosteal Abscess

Edited by: Edward El Rassi, MD

Highlights:
• Pre-operative CT shows a left subperiosteal abscess with an air-fluid level.
• Mucopurulent material is drained from adjacent ethmoid and maxillary sinuses.
• Skeletonized lamina papyracea demonstrates a bony defect.
• Portion of lamina papyracea is removed for adequate drainage of the subperiosteal abscess.

Keep in Mind:
• Orbital subperiosteal abscesses typically arise from untreated acute ethmoiditis.
• Inflammed, edematous tissue from the acute infection will be encountered throughout the surgical dissection.
• Adequate decompression of the lamina papyracea is necessary to ensure adequate drainage and prevent recollection. Care should be taken not to injure the underlying periorbita and expose orbital fat.
• Culture directed antibiotic therapy is necessary to ensure complete resolution of the infection.