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Endoscopic drainage of orbital abscesses aided with intraoperative sonography
Affiliations- Department of Neurosurgery, Medical University of Bialystok, Poland
- Department of Otolaryngology, Medical University of Bialystok, Poland
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Abstract
Accurate localization and adequate visualization of the superiorly or inferiorly located subperiosteal orbital abscesses or intraorbital abscess is difficult with transnasal endoscopic approach. Sonography is a well-known and effective tool for evaluation of orbital pathologies but no paper documenting intraoperative application of this method in orbital abscess surgery has been published to date.
Material and methodsWe present a series of 12 patients in whom orbital abscesses were drained endoscopically with an aid of neuronavigation and intraoperative ultrasonography. The abscesses were localized subperiosteally in the medial (n=6), superior (n=2) or inferior (n=1) part of the orbit whereas in 3 patients the abscess was localized in the intraconal space.
ResultsAccording to intraoperative sonographic imaging complete drainage of the abscess was achieved in 11 out of 12 patients and no complications occurred. Intraoperative sonography helped to limit opening of the orbital wall in the medial subperiosteal abscesses, enabled check-up for completeness of drainage of the far extending pouches in the superior and inferior subperiosteal abscesses and enabled visualization of the tip of surgical instrument when reaching deeply located intraorbital abscesses.
ConclusionsIntraoperative ultrasonography facilitates the endoscopic management of orbital abscesses, especially those which are difficult to reach due to subperiosteal location in the superior and inferior parts of the orbit, or abscesses localized intraorbitally.
Abstract
Accurate localization and adequate visualization of the superiorly or inferiorly located subperiosteal orbital abscesses or intraorbital abscess is difficult with transnasal endoscopic approach. Sonography is a well-known and effective tool for evaluation of orbital pathologies but no paper documenting intraoperative application of this method in orbital abscess surgery has been published to date.
Material and methodsWe present a series of 12 patients in whom orbital abscesses were drained endoscopically with an aid of neuronavigation and intraoperative ultrasonography. The abscesses were localized subperiosteally in the medial (n=6), superior (n=2) or inferior (n=1) part of the orbit whereas in 3 patients the abscess was localized in the intraconal space.
ResultsAccording to intraoperative sonographic imaging complete drainage of the abscess was achieved in 11 out of 12 patients and no complications occurred. Intraoperative sonography helped to limit opening of the orbital wall in the medial subperiosteal abscesses, enabled check-up for completeness of drainage of the far extending pouches in the superior and inferior subperiosteal abscesses and enabled visualization of the tip of surgical instrument when reaching deeply located intraorbital abscesses.
ConclusionsIntraoperative ultrasonography facilitates the endoscopic management of orbital abscesses, especially those which are difficult to reach due to subperiosteal location in the superior and inferior parts of the orbit, or abscesses localized intraorbitally.
Keywords
Orbital abscess, Surgical treatment, Endoscopy, Orbital ultrasonography
About this articleTitle
Endoscopic drainage of orbital abscesses aided with intraoperative sonography
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
315-321
Page views
225
Article views/downloads
549
DOI
10.1016/j.pjnns.2014.08.001
Bibliographic record
Neurol Neurochir Pol 2014;48(5):315-321.
Keywords
Orbital abscess
Surgical treatment
Endoscopy
Orbital ultrasonography
Authors
Tomasz Lyson
Andrzej Sieskiewicz
Robert Rutkowski
Jan Kochanowicz
Małgorzata Rozanska
Marek Rogowski
Zenon Mariak
