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The Acute Orbit: Preseptal (Periorbital) cellulitis, subperiosteal abscess and orbital cellulitis due to sinusitis

Published online by Cambridge University Press:  09 November 2023

J. R. Moloney ,
N. J. Badham  and
A. McRae
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Extract

Preseptal (periorbital) cellulitis, subperiosteal abscess and orbital cellulitis are conditions which are still frequently seen in ENT, Ophthalmic and Paediatric practice. They are parts of the spectrum of the disease processes seen in the acutely inflamed orbit. The clinician should try and establish which of the three conditions the patient has, as both subperiosteal abscess and orbital cellulitis are more serious conditions than preseptal cellulitis.

There is still much confusion in the literature over the terms ‘periorbital cellulitis’ and ‘orbital cellulitis', and the terms are often used interchangeably. This makes an analysis of the literature with regard to the features of the conditions difficult. The introduction of the term ‘the acute orbit’ might possibly lead to less confusion ifitisusedto cover all inflammatory processes in the orbit. Descriptions, definitions and classifications of orbital inflammations have been given by many authors in the literature. There are many causes of the acute orbit, but sinusitis remains the commonest cause.

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References

Ahrens-Palumbo, M. J. and Ballen, P. H. (1982) Primary dacryocystitis causing orbital cellulitis. Annals of Ophthalmology, 14: 6001.Google ScholarPubMed
Amies, D. R. (1974) Orbital cellulitis. Journal of Laryngology and Otology, 88: 559-564CrossRefGoogle ScholarPubMed
Asherson, N. (1939) A case of ptrositis, simulating orbital cellulitis. Journal of Laryngology and Otology, 54: 485-486.CrossRefGoogle Scholar
AxElsson, A. and Brorson, J. E. (1973). The correlation between bacteriological findings in the nose and maxillary sinus in acute maxillary sinusitis. Laryngoscope, 83: 2003-2011.CrossRefGoogle ScholarPubMed
Barkin, R. M. and Todd, J. K. (1978) Periorbital cellulitis in children. Paediatrics, 62: 390-392.CrossRefGoogle ScholarPubMed
Bell, R. W. (1971) Orbital cellulitis and cavernous sinus thrombosis caused by rhabdomyosarcoma of the middle ear. Annals of Ophthalmology, 4: 1090-1092.Google Scholar
Bilaniuk, L. T. and Zimmerman, R. A. (1980) Computer-assisted tomography: sinus lesions with orbital involvement. Head and Neck Surgery, 2: 293-301.CrossRefGoogle ScholarPubMed
Braverman, D. E. and Jumsch, G. F. (1978) Unusual case of acute orbital cellulitis. Journal of Paediatric Ophthalmology and Strabismus, 15: 103-106.CrossRefGoogle ScholarPubMed
Burnard, E. D. (1959) Proptosis as the first sign of orbital sepsis in the new born. British Journal of Ophthalmology, 43: 9-12.CrossRefGoogle Scholar
Chandler, J. R., Langenbrunner, D. J. and Stevens, E. R. (1970) The pathogenesis oforbitalcomplicationsin acute sinusitis. Laryngoscope, 80: 1414-1428.CrossRefGoogle ScholarPubMed
Davis, E. D. D. (1937) Orbital cellulitis due to sinus infection and its treatment. Journal of Laryngology and Otology, 25: 834-848.Google Scholar
Duke-Elder, S. (1952) Textbook of Ophthalmology, Volume 5, pages 544G-5443 and Volume 6, pages 5420-5425. London, Kimpton.Google Scholar
Duke-Elder, S. and MacFaul, P. A. (1974) System of Ophthalmology, Volume 13, pages 859-889. Henry Kimpton, London.Google Scholar
Elitsur, Y., Biedner, B. Z. and Bar-Ziv, J. (1984) Ethmoiditis, conjunctivitis and orbital cellulitis due to Enterococcus infection. Clinical Pediatrics (Philadelphia), 23: 123.Google ScholarPubMed
El Shewy, T. M. (1973) Acute infarction of the choroid and retina-a complication of orbital cellulitis. British Journal of Ophthalmology, 51: 204-205.CrossRefGoogle Scholar
Feingold, M. and Gellis, S. S. (1965) Cellulitis due to Haemophylus influenzae Type B. New England Journal of Medicine, 212: 788-789.CrossRefGoogle Scholar
Forstot, S. L. and Ellis, P. P. (1979) Nontraumatic rupture of the globe secondary to orbital cellulitis. American Journal of Ophthalmology, 88: 262-264.CrossRefGoogle ScholarPubMed
Frederick, J. and Braude, A. I. (1974) Anaerobic infection of the paranasal sinuses. New England Journal of Medicine, 290: 135-137.CrossRefGoogle ScholarPubMed
Gamble, R. C. (1937) Orbital abscesses. Archives of Ophthalmology, 18: 633-641.CrossRefGoogle Scholar
Gans, H., Sekula, J. and Wlodyka, J. (1974) Treatment of acute orbital complications. Archives of Otolaryngology, 100: 329-332.CrossRefGoogle ScholarPubMed
Garrod, L. P., Lambert, H. P. and O'Grady, F. (1981) Antibiotic and Chemotherapy 5th Edition Churchill Livingstone, pages 276-277.Google Scholar
Gellady, A. M., Shulman, S. T. and Ayoub, E. M. (1978) Periorbital and orbital cellulitis in children. Pediatrics, 61: 272-277.CrossRefGoogle ScholarPubMed
Gold, R. S., Silver, L. J., Sager, E. and Vineland, N. J. (1974) Pansinusitis, orbital cellulitis, and blindness as sequelae of delayed treatment of dental abscess. Journal of Oral Surgery, 32: 40-43.Google ScholarPubMed
Goldberg, F., Berne, A. S. and Oski, F.A. (1978) Differentiation of orbital cellulitis from preseptal cellulitisby computed tomography. Pediatrics, 62: 1000-1005.CrossRefGoogle ScholarPubMed
Gomez-Barreto, J. and Nahmias, A. J. (1977) Hypopyon and orbital cellulitis associated with Haemophilus influenzae Type B meningitis. American Journal of Diseases of Children, 131: 215-217.CrossRefGoogle Scholar
Goodwin, W. J., Weinshall, M. and Chandler, J. R. (1982) The role of high resolution computerised tomography and standardised ultrasound in the evaluation of orbital cellulitis. Laryngoscope, 92: 728-731.CrossRefGoogle ScholarPubMed
Guindi, G. M. (1983) Acute orbital cellulitis: a multidisciplinary emergency. British Journal of Oral Surgery, 21: 201-207.CrossRefGoogle ScholarPubMed
Harley, M. J. and Guerier, T. H. (1978) Orbital cellulitis related to an influenza A vin.is epidemic. British Medical Journal, 2: 13-14.CrossRefGoogle Scholar
Harris, G. J., Kay, M. C. and Nilles, J. J. (1978) Orbital haematoma secondary to frontal sinusitis. Ophthalmology, 85: 1229-1234.CrossRefGoogle ScholarPubMed
Harrison, D. F. N. (1980) The ENT surgeon looks at the orbit. Journal of Laryngology and Otology, Supplement 3: pages 21-24 and 42-43.CrossRefGoogle Scholar
Hawkins, D. B. and Clark, R. W. (1977) Orbital involvement in acute sinusitis. Lessons from 22 childhood patients. Clinical Pediatrics, 16: 464-471.CrossRefGoogle Scholar
Haynes, R. E. and Crambleti, H. G. (1967) Acute ethmoiditis: Its relationship to orbital cellulitis. American Journal of Diseases of Children, 114: 261-267.CrossRefGoogle ScholarPubMed
Healy, G. B. and Strong, M. S. (1972) Acute periorbital swelling. Laryngoscope, 82: 1491-1498.CrossRefGoogle ScholarPubMed
HowArd, G. M. and Eluorth, R. M. (1965) Differential diagnosis of retinoblastoma: a statistical survey of 500 children. American Journal of Ophthalmology, 60: 618-621.CrossRefGoogle ScholarPubMed
Hubert, L. (1937) Orbital infections due to nasal sinusitis. New York State Journal of Medicine, 37: 1559-1564.Google Scholar
Jacobs, M. R. et al. (1978) Emergence of multiply resistant pneumococci. New England Journal of Medicine, 299: 735-740.CrossRefGoogle ScholarPubMed
Jarreti, W. H. and Gutman, F. A. (1969) Ocular complications of infection in the paranasal sinuses. Archives of Ophthalmology, 81: 683-688.CrossRefGoogle Scholar
Juoisch, G. F. and Apple, D. J. (1980) Orbital cellulitis in an infant secondary to Coats’ disease. Archives of Ophthalmology, 98: 2004-2006.CrossRefGoogle Scholar
Kaban, L. B. and McGill, T. (1980) Orbital cellulitis of dental origin: differential diagnosis and the use of computed tomography as a diagnostic aid. Journal of Oral Surgery, 38: 682-685.Google ScholarPubMed
Kander, P. L. and Leaver, P. K. (1974) Orbital apex syndrome complicating frontal pyocoele. Journal of Laryngology and Otology, 88: 551-557.CrossRefGoogle ScholarPubMed
Kerkenezov, N. (1955) Acute non-specific infection of the orbit with a report of three cases. Medical Journal of Australia, 2: 293-295.CrossRefGoogle Scholar
Kroll, A. J. and Casten, V. G. (1966) Diseases of the orbit, in Liebman S. D. and Gellis S. S. (eds) the Pediatricians Ophthalmology, St Louis C.V. Mosby Company, pages 231-244.Google Scholar
Lanning, C. (1964) Orbital cellulitis in children. Clinical Proceedings of the Children's Hospital Washington, 10: 140-146.Google Scholar
Leeson, P. (1959) A case oforbital cellulitis secondary to suppurative pansinusitis: Jacksonian epilepsy: drainage of the sinuses: recovery. Journal of Laryngology and Otology, 73: 392-395.CrossRefGoogle Scholar
Limongelli, W. A., Clark, M. S. and Williams, A. C. (1977) Panfacial cellulitis with contralateral orbital cellulitis and blindness after tooth extraction. Journal of Oral Surgery, 35: 38-43.Google ScholarPubMed
Londer, L. and Nelson, D. L. (1974) Orbital cellulitis due to Haemophilus inftuenzae. Archives of Ophthalmology, 91: 89-91.CrossRefGoogle Scholar
Macy, J. I., Mandelbaum, S. H. and Minckler, D. S. (1980) Ocular Pathology for Clincians. 8. Orbital Cellulitis. Ophthalmology (Rochester), 87: 1309-1313.CrossRefGoogle Scholar
Medina, D. A. and Fine, R. N. (1967) Haemophilus influenzae Type B orbital cellulitis. California Medicine, 107: 181-183.Google Scholar
Mills, R. P. (1986) Orbital infection and sinusitis. Journal of the Royal Society of Medicine, 79: 68-69.CrossRefGoogle ScholarPubMed
Mills, R. P. and Kartush, J. M. (1985) Orbital wall thickness and the spread of infection from the paranasal sinuses. Clinical Otolaryngology, 10: 209-216.CrossRefGoogle ScholarPubMed
Morgan, P. R. and Morrison, W. V. (1980) Complications of frontal and ethmoid sinusitis. Laryngoscope, 90: 661-666.CrossRefGoogle ScholarPubMed
Myging, L. (1937) Discussion of orbital cellulitis due to sinus infection and its treatment. Journal of Laryngology and Otology, 25: 839-842.Google Scholar
Nadol, J. B. (1977) Pseudocellulitis of the orbit. Annals of Otology, Rhinology and Laryngology, 86: 86-88.CrossRefGoogle ScholarPubMed
Newell, F. W. and Leveille, A. S. (1982) Management and complications of bacterial periorbital and orbital cellulitis. Metabolic Pediatric and Systemic Ophthalmology, 6: 209-214.Google ScholarPubMed
Noel, L. P., Clarke, W. N. and Peacocke, T. A. (1981) Periorbital and orbital cellulitis in childhood. Canadian Journal of Ophthalmology, 16: 178-180.Google ScholarPubMed
Partamian, L. G., Jay, W. M. and Fritz, K. J. (1983) Anaerobic orbital cellulitis. Annals of Ophthalmology, 15: 123-126.Google ScholarPubMed
Price, C. D., Hameroff, S. B. and Richards, R. D. (1971) Cavernous sinus thrombosis and orbital cellulitis. Southern Medical Journal, 64: 1243-1247.CrossRefGoogle ScholarPubMed
Quick, C. A. and Payne, E. (1972) Complicated acute sinusitis. Laryngoscope, 82: 1248-1263.CrossRefGoogle ScholarPubMed
Rapkin, R. H. and Bautista, G. (1972) Hemophilus influenzae cellulitis. American Journal of Diseases of Children, 124: 540-542.Google ScholarPubMed
Reddy, C. M. (1978) Case report. Ampicillin-resistant Hemophilus influenzae Type B orbital cellulitis. Journal of the Tennessee Medical Association, 71: 192-193.Google ScholarPubMed
Robbins, K. T. and Tarshis, L. M. (1981) Blindness, a complication of odontogenic sinusitis. Otolaryngology, Head and Neck Surgery, 89: 938-940.CrossRefGoogle ScholarPubMed
Robie, G., O'Neal, R. and Kelsey, D. S. (1977) Periorbital cellulitis. Journal of Pediatric Ophthalmology, 14: 354-363.Google ScholarPubMed
Rubinstein, J. B. and Handler, S. D. (1982) Orbital and periorbital cellulitis in children. Head and Neck Surgery, 5: 15-21.CrossRefGoogle ScholarPubMed
Schramm, V. L., Myers, E. N. and Kennerdell, J. S. (1978) Orbital complications of acute sinusitis: Evaluation, managment, and outcome. Otolaryngology, 86: 221-230.CrossRefGoogle ScholarPubMed
Schramm, V. L., Curtin, H. D. and Kennerdell, J. S. (1982) Evaluation of orbital cellulitis and results of treatment. Laryngoscope, 92: 732-738.CrossRefGoogle ScholarPubMed
Schwartz, H., Baskin, M.A., Llkiw, A. and Lebeau, L. (1979) An unusual organism causing orbital cellulitis. British Journal of Ophthalmology. 63: 710-712.CrossRefGoogle ScholarPubMed
Scorr, G. I. (1960) Orbital cellulitis and cavernous sinus thrombosis. Transactions of the Ophthalmological Society of the United Kingdom, 80: 435-450.Google Scholar
Sen, D. K. (1980) Cysticercus cellulosae in the lacrimal gland, orbit and eyelid. Acta Ophthalmologica, 58: 144-147.CrossRefGoogle Scholar
Sevel, D., Tobias, B., Sellars, S. L. and Forder, A. (1973) Gas in the orbit associated with orbital cellulitisand paranasal sinusitis. British Journal of Ophthalmology, 57: 133-137.CrossRefGoogle Scholar
Shapiro, E. D., Wald, E. R. and Brozanski, B. A. (1982) Periorbital cellulitis and paranasal sinusitis: a reappraisal. Pediatric Infectious Disease, 1:91-94.CrossRefGoogle ScholarPubMed
Smelt, G. J. C. and Migdal, C. S. (1983) Acute blinding sinusitis. British Medical Journal, 287: 1051-1052.CrossRefGoogle ScholarPubMed
Smith, A. T. and Spencer, J. F. (1948) Orbital complications resulting from lesions of the sinuses. Annals of Otology, Rhinology and Laryngology, 57: 5-27.CrossRefGoogle ScholarPubMed
Smith, T. F., O'Day, D. and Wright, P. F. (1978) Clinical implications of preseptal (periorbital) cellulitis in childhood. Pediatrics, 62: 1006-1009.CrossRefGoogle ScholarPubMed
Stone, A. and Stratigos, G. T. (1979) Mandibular odontogenic infection with serious complications. Oral Surgery, Oral Medicine, Oral Pathology, 47: 395-400.CrossRefGoogle ScholarPubMed
Snyderman, N. L. and Stool, S. E. (1982) Management of airway obstruction in children with infectious mononucleosis. Otolaryngology, Head and Neck Surgery, 90: 168-170.CrossRefGoogle ScholarPubMed
Thatcher, D. B. (1967) Necrotic choroidal melanoma presenting with severe inflammation. Survey of Ophthalmology, 12: 247-253.Google ScholarPubMed
Von Noorden, G. K. (1972) Orbital cellulitis following extraocular muscle surgery. American Journal of Ophthalmology, 74: 627-629.CrossRefGoogle ScholarPubMed
Wald, E. R., Pang, D., Milmoe, G. J. and Schramm, V. L. (1981) Sinusitis and its complications in the pediatric patient. Pediatric Clinics of North America, 28: 777-796.CrossRefGoogle ScholarPubMed
Watters, E. C., Wallar, P. H., Hiles, D. A. and Michaels, R. H. (1976) Acute orbital cellulitis. Archives of Ophthalmology, 94: 785-788.CrossRefGoogle ScholarPubMed
Weiss, A., Friendly, D., Eglin, K., Chang, M. and Gold, B. (1983) Bacterial periorbital and orbital cellulitis in childhood. Ophthalmology, 90: 195-203.CrossRefGoogle ScholarPubMed
Weiss, I. S. (1979) Pseudomonas orbital cellulitis. American Journal of Ophthalmology, 87: 368-370.CrossRefGoogle ScholarPubMed
Weizman, Z., Thnembaum, A., Perlman, M. and Sahar, A. (1981) Orbital meningocele presenting as periorbital cellulitis. Child's Brain, 8: 207-210.Google ScholarPubMed
Welsh, L. W. and Welsh, J. J. (1974) Orbital complications of sinus disease. Laryngoscope, 84: 848-856.CrossRefGoogle Scholar
Yates, C. and Monks, A. (1978) Orbital cellulitis complicatfog the extraction of111fected teeth. Journal of Dentistry, 6: 229-232.CrossRefGoogle ScholarPubMed