Endoscopic management of subperiosteal abscesses

While the progression of acute rhinosinusitis to orbital infections has decreased in the modern antibiotic era, they still occur, particularly in the pediatric population. Infection may spread from the nasal cavity and sinuses via direct extension into the orbit through the thin lamina papyracea or through the valveless veins in the bony orbital wall. Congenital dehiscence and trauma also allow for direct extension of the infection to the orbit. Most of these orbital infections originate in the ethmoid sinuses and subperiosteal abscesses most commonly occur along the medial orbital wall. However, the frontal sinus is implicated in superior abscesses in older children and adults. Postseptal orbital infections require prompt diagnosis and treatment as they may impact vision and progress centrally, manifesting as cavernous sinus and intracranial infections associated with significant morbidity and mortality. This article describes endoscopic surgical management of medial and superior subperiosteal abscess.