臨床
経鼻内視鏡的ドレナージを行った小児眼窩骨膜下膿瘍例
2020 年 113 巻 1 号 p. 31-35
詳細
2020 年 113 巻 1 号 p. 31-35
A subperiosteal abscess (SPA) of the orbit is a serious complication of sinusitis in children. Here we present a case of a 6-year-old boy with SPA treated with endoscopic surgical intervention. Computed tomography (CT) revealed acute sinusitis and a left medial SPA. He was treated with meropenem intravenously for 2 days. However, the cavity of the SPA appeared enlarged in a follow-up CT. Transnasal endoscopic sinus surgery was performed and the SPA was drained on the same day. An SPA is a serious stage of orbital infections which can lead to blindness and cavernous sinus thrombosis. Although the timing of the surgical intervention is controversial, we safely drained the SPA with transnasal endoscopic surgery, without any subsequent complications.
In the treatment of orbital subperiosteal abscesses, conservative treatment is given first. Generally, conservative treatment in children is said to be more effective than in adults. However, in cases with a poor response to conservative treatment, it is necessary to carry out surgical treatment promptly. If treatment is delayed, irreversible visual damage may occur or intracranial complications may lead to death, so prompt and appropriate measures are essential.
