Endoscopic Drainage

by admin on November 11, 2011

About Dr. Rande Lazar

Memphis Otolaryngologist Dr. Rande Lazar primarily focuses in pediatric ear, nose and throat disorders, including ear infections, throat infections, tonsil infections, sinus infections and sleep disorders. Dr. Lazar has special expertise in adult and pediatric sleep and snoring disorders and surgery, as well as adult and pediatric sinus disorders. Hi experience crosses a wide range of disorders of the ear, nose, throat, sinus and respiratory systems, as well as other head and neck systems. He also focuses in children’s disorders of the larynx (voicebox), and hearing problems.

Dr. Rande Lazar is the founder of the Memphis-based pediatric ear, nose and throat practice, Otolaryngology Consultants.

Article Abstract:

Subperiosteal abscess is a serious orbital complication of sinusitis that occurs predominantly in children. Infection may spread to the orbital site through a preexisting defect in the lamina papyracea or by means of a thrombophlebitic process. Although the traditional approach to treating a subperiosteal abscess has been drainage through an external incision, we treated this serious complication with functional endonasal sinus surgery. Ten pediatric patients with clinical and CT evidence of orbital subperiosteal abscess underwent endoscopic surgery at LeBonheur Children’s Hospital in Memphis, Tenn., between 3 and 12 years of age at the time of surgery. Despite 2 to 4 days of intravenous antibiotic therapy, their signs and symptoms progressed, and axial and coronal CT scans demonstrated orbital subperiosteal abscess. Seven patients had bilateral ethmoid and maxillary sinusitis, and the remaining three patients had unilateral ethmoiditis. Opthalmologic assessments were performed for all patients immediately after hospital admission. The patients were started on regimens of high-dose intravenous cefuroxime sodium to subdue infections and pediatric decongestant nasal spray to facilitate drainage. All 10 patients with the confirmed diagnosis of subperiosteal abscess were treated with endoscopic surgery to drain the site of infection. All 10 patients improved significantly 12 to 24 hours after surgery and were discharged from the hospital to their homes 48 to 72 hours after surgery. Patients were continued on a regimen of broad-spectrum oral antibiotics and beclomethasone nasal spray for 2 weeks beyond the final examination. Follow-up endoscopic examinations were performed under general anesthesia in the operating room 2 to 3 weeks after surgery. No complications or adverse sequelae occurred. Our study appears to confirm that endoscopic drainage of subperiosteal abscess offers the patient an alternative to incisional surgery. The endoscopic approach prevents an external scar without increasing morbidity or length of hospitalization.

Read the full article as a PDF here: Endoscopic Drainage of Subperiosteal Abscess in Children: A Pilot Study

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