Endoscopic surgery for the treatment of pediatric subperiosteal orbital abscess: A report of 10 cases

Introduction: The pediatric subperiosteal abscess is considered an infectious process characterized by an abscess pocket localized between the lamina papiracea and the periorbita. Usually the surgical management is used to drain the collection of pus. Methods: Between January 2006 and January 2009, 10 patients of age under 18-year-old underwent through a transnasal endoscopic approach at the University of Bologna, Sant'Orsola Malpighi Hospital for the treatment of a subperiosteal orbital abscess. All these patients were taken to the operative room in order to drain the abscess only after that the CT scan was accomplished and it demonstrated the presence of a subperiosteal orbital abscess. Results: The transnasal endoscopic approach was used alone in 9 cases while it was associated with an external approach in one case for the treatment of a superolateral based subperiosteal orbital abscess. In all cases the exudate was obtained during the surgical procedure for the microbiological examination, although only 2 out of 10 cases had positive abscess cultures for Streptococcus pneumoniae. Conclusions: The transnasal endoscopic approach is an effective surgical treatment to drain the collection of pus in all medially based subperiosteal orbital abscess, while it can be associated with an external approach for the treatment of a superolateral based subperiosteal orbital abscess. (C) 2009 Elsevier Ireland Ltd. All rights reserved.