Skip to main content

The acute orbit: differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography

Summary

A series of 65 patients suffering from acute inflammatory disease of the orbit was studied by CT. Ethmoiditis was the cause in the vast majority; trauma and dental extraction played a lesser role in causation. Orbital cellulitis was diagnosed in 17 and subperiosteal abscess in the remaining 48. It was not possible to differentiate 33 pus-containing abscesses from the six with inflammatory masses (phlegmons). The satisfactory response to aggressive medical treatment in those patients with inflammatory masses that were not drained justifies a more conservative approach; surgical drainage being reserved for those with a deterioration in proptosis, ocular movements or vision. Six abscesses arose de novo, of which some were in the orbital fat rather than the subperiosteal space.

This is a preview of subscription content, access via your institution.

References

  1. 1.

    Towbin R, Han BK, Kaufman RA, Burke M (1986) Postseptal cellulitis: CT in diagnosis and management. Radiology 158: 735–737

    Google Scholar 

  2. 2.

    Eustis HS, Armstrong DC, Buncic JR, Morris JD (1986) Staging of orbital cellulitis in children: computerized tomography characteristics and treatment guidelines. J Pediatr Ophthalmol Strabismus 23: 246–251

    Google Scholar 

  3. 3.

    Rubin SE, Rubin LG, Zito J, Goldstein MN, Eng C (1989) Medical management of orbital subperiosteal abscess in children. J Pediatr Ophthalmol Strabismus 26: 21–26

    Google Scholar 

  4. 4.

    Hammerschlag SB, Hesselink JR, Weber AL (1983) Inflammatory disease. In: Computed tomography of the eye and orbit. Appleton-Century-Crofts, Norwalk, pp 25, 159–181

    Google Scholar 

  5. 5.

    Moloney JR, Badham NJ, McRae A (1987) The acute orbit: preseptal (periorbital) cellulitis subperiosteal abscess and orbital cellulitis due to sinusitis. J Laryngol Otol [Suppl] 12: 1–18

    Google Scholar 

  6. 6.

    Mauriello JA, Flanagan JC (1984) Management of orbital inflammatory disease. A protocol. Surv Ophthalmol 29: 104–116

    Google Scholar 

  7. 7.

    Hornblass A, Herschorn BJ, Stern K, Grimes C (1984) Orbital abscess. Surv Ophthalmol 29: 169–178

    Google Scholar 

  8. 8.

    Gold SC, Arigg PG, Hedges TR (1987) Computerized tomography in the management of acute orbital cellulitis. Ophthalmic Surg 18: 753–756

    Google Scholar 

  9. 9.

    Chandler JR, Langenbrunner DJ, Stevens ER (1970) The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 80: 1414–1428

    Google Scholar 

  10. 10.

    Tanenbaum M, Tenzel J, Byrne SF, Forster RK (1985) Medical management of orbital abscess (letter). Surv Ophthalmol 30: 211–212

    Google Scholar 

  11. 11.

    Harris GJ (1983) Subperiosteal abscess of the orbit. Arch Ophthalmol 101: 751–757

    Google Scholar 

Download references

Author information

Affiliations

Authors

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Handler, L.C., Davey, I.C., Hill, J.C. et al. The acute orbit: differentiation of orbital cellulitis from subperiosteal abscess by computerized tomography. Neuroradiology 33, 15–18 (1991). https://doi.org/10.1007/BF00593326

Download citation

Key words

  • Orbital abscess
  • Subperiosteal abscess
  • Orbital cellulitis
  • Proptosis
  • Phlegmon