Endoscopic orbital subperiosteal abscess drainage

The antrum of the anterior group is adjacent to the upper wall, the inner wall and the lower wall of the iliac crest. The posterior sinus is closely related to the optic nerve in the posterior part of the posterior wall of the iliac crest. Eyelid infection is the most common complication of sinusitis, and all sinusitis can cause nasal origin. Complications within the sputum. In 1970, Chandler divided the nasal eyelid infection into the following five stages: 1. Periorbital inflammatory edema. 2. Eyelid cellulitis. 3. Subperiosteal abscess. 4. Eyelid abscess. 5. Cavernous sinus thrombosis. Subperiosteal abscess refers to the accumulation of pus between the inner wall of the iliac crest and the periosteum. The clinical manifestations are tenderness of the eyeball, conjunctival hyperemia, outward and downward displacement of the eyeball, limited movement, often accompanied by symptoms of systemic poisoning such as fever. No vision loss. If the abscess ruptures, it can form eyelid cellulitis or form a fistula in the medial malleolus. Endoscopic subperiosteal abscess drainage has the following advantages: 1 subperiosteal abscess caused by ethmoid sinusitis, through the ethmoid sinus drainage approach can directly remove the source of infection, so that the abscess is drained to the nasal cavity. 2 to avoid facial scars of extranasal ethmoidectomy. Treatment of diseases: sinusitis Indication 1. Abscess is confined to the subperiosteal space. 2. Abscess can be drained through the paper plate (medial subperiosteal abscess). Preoperative preparation CT and MRI examination of the sinuses and eyes to determine sinus inflammation, as well as the location and extent of the abscess. Surgical procedure According to Messerklinger's anterior and posterior approach, ethmoidectomy was performed to completely stop bleeding. Because the infection is mostly transmitted from the ethmoid sinus to the eyelids, the ethmoid paper template often has partial rupture (deletion). Use a small curette to remove enough paper plates to facilitate drainage of the abscess toward the ethmoid sinus. The subperiosteal abscess is located between the paper plate and the periosteum. During the process of removing the paper plate, purulent secretions can flow out toward the ethmoid sinus. In order to avoid the spread of infection, try not to damage the periosteum. Absorb the pus with an aspirator and send a bacterial culture and antibiotic susceptibility test. Rinse the abscess with saline, do not fill the nasal cavity, and the surgery is over. complication 1. Eye muscle damage. 2. Optic nerve damage.

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