Pediatric subperiosteal orbital abscess characterization and prediction of size, location, and management

• Published in: International journal of pediatric otorhinolaryngology 2021-05, Vol.144, p.110693-110693, Article 110693
• Main Authors: McCoy, Jennifer L., Dixit, Ronak, Dohar, Joseph E., Tobey, Allison B.J.
• Format: Article
• Language: English
• Subjects: Abscess - diagnostic imaging; Abscess - etiology; Abscess - surgery; Anti-Bacterial Agents - therapeutic use; Child; Drainage; Female; Humans; Male; Orbital Cellulitis - diagnostic imaging; Orbital Cellulitis - etiology; Orbital Diseases - diagnostic imaging; Orbital Diseases - etiology; Pediatric; Periosteum; Retrospective Studies; Sinusitis; Sinusitis - drug therapy; Subperiosteal orbital abscess; Surgical intervention
• ISSN: 0165-5876; 1872-8464
• DOI: 10.1016/j.ijporl.2021.110693

Subperiosteal orbital abscess (SPOA) is a serious suppurative complication of pediatric sinusitis. The objective of this study is to stratify patient selection into those best treated medically versus surgically based on clinical outcomes. This is a retrospective review of patients diagnosed with SPOA complicating sinusitis treated at a tertiary care pediatric hospital from 2002 through 2016. SPOA was diagnosed by CT scan. Characteristics evaluated include demographics, abscess size, location, and measurements, length of hospital stay, medical and surgical interventions, presenting symptoms, and complications. A total of 108 total SPOA secondary to sinusitis patients were included. A majority, 72.2%, were male with an average age at presentation of 6.8 years. The mean ± standard deviation abscess cubic volume was 0.98 ± 1.27 cm3 (median(range) = 0.44(0.01–7.34 cmcm3)). With an abscess volume of 0.510 cm3, there was a sensitivity of 71.2% and a specificity of 84.4% for needing surgical drainage. Those with large abscesses at our volume threshold were 13 times more likely to require surgery than those with small abscesses, OR: 13.41, 95%CI: 5.02–35.86, p