Hostname: page-component-586b7cd67f-t8hqh Total loading time: 0 Render date: 2024-11-29T12:06:58.206Z Has data issue: false hasContentIssue false
  • English
  • Français

Posterior orbital cellulitis: case report and literature review

Published online by Cambridge University Press:  29 October 2013

K Allan ,
H Atkinson  and
F Agada
H Atkinson
Affiliation:
ENT, Head and Neck Surgery Department, York Teaching Hospitals NHS Trust, Scarborough Hospital, UK
F Agada
Affiliation:
ENT, Head and Neck Surgery Department, York Teaching Hospitals NHS Trust, Scarborough Hospital, UK
Get access Rights & Permissions [Opens in a new window]

Abstract

Introduction:

It is rare for isolated sphenoid sinusitis to cause orbital cellulitis. We present a rare case of posterior orbital cellulitis, so caused, together with a review of the relevant literature.

Case report:

A 29-year-old woman presented with a 6-week history of progressive, unilateral, retro-orbital and periorbital right eye pain. On examination, the only finding was reduced visual acuity in the right eye. A computed tomography scan demonstrated right frontal and sphenoid sinus opacification. Sphenoidotomy and frontal sinus trephination were subsequently performed, following failure to respond to intravenous antibiotics. After surgery, the patient's vision returned to normal.

Conclusion:

Isolated sphenoid sinusitis is rare but can cause significant visual disturbance and permanent loss of vision. Vague symptoms unsupported by clinical signs at presentation are a feature of posterior orbital cellulitis. The presented case highlights the problem, and the need for a high index of clinical suspicion even in the absence of firm clinical signs, in order to prevent permanent visual loss.

Keywords

Sphenoid SinusSinusitisOrbital CellulitisDiagnosis
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 127 , Issue 11 , November 2013 , pp. 1148 - 1151
Copyright
Copyright © JLO (1984) Limited 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Van Alyea, OE. Sphenoid sinus: anatomic study, with consideration of the clinical significance of the structural characteristics of the sphenoid sinus. Arch Otolaryngol 1941;34:225–53CrossRefGoogle Scholar
2Holt, GR, Standefer, JA, Brown, WE Jr, Gates, GA. Infectious diseases of the sphenoid sinus. Laryngoscope 1984;94:330–5CrossRefGoogle ScholarPubMed
3Lew, D, Southwick, FS, Montgomery, WW, Weber, AL, Baker, AS. Sphenoid sinusitis. A review of 30 cases. N Engl J Med 1983;309:1149–54CrossRefGoogle ScholarPubMed
4Pearlman, SJ, Lawson, W, Biller, HF, Friedman, WH, Potter, GD. Isolated sphenoid sinus disease. Laryngoscope 1989;99:716–20CrossRefGoogle ScholarPubMed
5Chandler, JR, Langenbrunner, DJ, Stevens, ER. The pathogenesis of orbital complications in acute sinusitis. Laryngoscope 1970;80:1414–28CrossRefGoogle ScholarPubMed
6Kjoer, I. A case of orbital apex syndrome in collateral pansinusitis. Acta Ophthalmologica 1945;23:357–66CrossRefGoogle Scholar
7Slavin, ML, Glaser, JS. Acute severe irreversible visual loss with sphenoethmoiditis – ‘posterior orbital cellulitis’. Arch Ophthalmol 1987;105:345–8CrossRefGoogle ScholarPubMed
8Guo, YF, Yuan, YM, Liu, ZP, Xu, BC, Guan, J. Clinical analysis of sphenoid disease manifesting as orbital apex syndrome [in Chinese]. Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 2005;40:688–90Google ScholarPubMed
9Proetz, AW. The sphenoid sinus. Br Med J 1948;2:243–5CrossRefGoogle ScholarPubMed
10Brook, I. Bacteriology of acute and chronic sphenoid sinusitis. Ann Otol Rhinol Laryngol 2002;111:1002–4CrossRefGoogle ScholarPubMed