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Characteristics and management of pediatric medial subperiosteal orbital abscesses.

Authors :
Lu NE
Gardiner LA
McCoy JL
Dohar JE
Tobey ABJ
Source :
International journal of pediatric otorhinolaryngology [Int J Pediatr Otorhinolaryngol] 2024 Jul; Vol. 182, pp. 111997. Date of Electronic Publication: 2024 May 31.
Publication Year :
2024

Abstract

Introduction: Subperiosteal orbital abscesses (SPOA) are the most common suppurative complications of acute bacterial sinusitis. Medial SPOAs arise from infection of the ipsilateral ethmoid sinus and favor initial conservative management reserving surgical drainage for patients who do not demonstrate clinical improvement. No standard algorithm defining medical versus surgical treatment of medial SPOAs exist in the pediatric population.<br />Objectives: To identify a size cutoff for medial SPOAs to predict the likelihood for surgical drainage.<br />Methods: This is a retrospective review of patients with medial SPOAs at a tertiary care center from 2003 to 2017. Diagnosis of SPOA was based on radiographic findings. Variables included are patient demographics, antibiotic therapy, surgical intervention, and length of stay.<br />Results: 82 patients with a medial SPOA were included with an average age at presentation of 6.27 (range 0-15) years were included in this study. 62 patients were male (75.6 %), and 20 were female (24.4 %). The average abscess length was 16.1 mm, range 4.5-30.7 mm. The average abscess width was 4.17 mm, range 1.5-14.6 mm. The odds ratio for surgical treatment with every 1 mm increase in abscess width was 1.89 (95CI:1.33-2.69, p < 0.001). Abscesses over 3.6 mm width were 6.65 times more likely to undergo surgical drainage than those less than 3.6 mm (OR:6.65, 95CI:2.52-17.54, p < 0.001). The average(SD) length of stay was 5.4(3.0) days for patients who underwent surgery and 4.0(0.9) days for patients treated with conservative measures, p < 0.001.<br />Conclusion: Medial SPOAs greater than 3.6 mm were more likely to undergo surgical drainage; however there was no difference in the likelihood of drainage between anteriorly and posteriorly based medial abscesses. These findings help further characterize the landscape of pediatric subperiosteal abscesses that are managed with surgical drainage.<br />Competing Interests: Declaration of competing interest There are no conflicts of interest to report for any author.<br /> (Copyright © 2024. Published by Elsevier B.V.)

Details

Language :
English
ISSN :
1872-8464
Volume :
182
Database :
MEDLINE
Journal :
International journal of pediatric otorhinolaryngology
Publication Type :
Academic Journal
Accession number :
38852548
Full Text :
https://doi.org/10.1016/j.ijporl.2024.111997