Comparison of Surgical Approaches of Subperiosteal Abscess in Children

Huang SF, Lee TJ, Young CK and Wang CN

Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan
Department of Public Health, Chang Gung University, Taiwan
Department of Otolaryngology, Chang Gung Memorial Hospital, Taiwan
Universal eye center, Taiwan

^*Correspondance to: Shiang-Fu Huang 

 PDF  Full Text DOI: 10.25107/2474-1647.1095

Abstract

Background: Orbital subperiosteal abscesses (SPOAs) in children requires timely treatment for potential complications. The best surgical approaches for SPOAs were non-conclusive. In this study, we analyzed the treatment outcomes comparing different surgical approaches.Methodology: The medical records of children less than18 years old hospitalized from 1996 through 2007, at the Chang Gung Memorial Hospital, with a diagnosis of SPOAs confirmed by computed tomography scan were reviewed. Surgical intervention was indicated only with failed medical therapy, progression of symptoms, or onset of complications. For SPOAs located in the medial aspect of orbit, we use transnasal endoscopic (TNE) approach; SPOAs in the superior aspect of orbit, we use external (EXT) approach; and SPOAs in both the medial and superior aspects of orbit, we use combined approach.Results: Twenty-two patients, 14 boys and 8 girls, were identified (mean age, 5.45 years [range, 12 days to 18 years). Ten patients were treated with a TNE approach, 8 patients required an EXT approach and 4 patients received combined approach. The age of patients receiving EXT approach is significantly younger than other groups (ANOVA: P = 0.023). The most frequent symptoms were fever (100%) and the most involved sinus was maxillary sinus. The most frequently isolated organisms were Staphylococcus aureus, Streptococcus viridans, and Klebsiella pneumonia. One patient required repeated aspiration externally. All patients had eventual resolution of their disease without any surgical complications.Conclusion: The selection of surgical approach for pediatric SPOAs according to their radiographic location was proved successful in all our patients.

Keywords

Surgical; Subperiosteal; Children

Cite the article

Huang SF, Lee TJ, Young CK, Wang CN. Comparison of Surgical Approaches of Subperiosteal Abscess in Children. Clin Surg. 2016; 1: 1095.