J Korean Ophthalmol Soc.  2008 Nov;49(11):1845-1849.

Orbital Cellulitis With Subperisoteal Abscess Secondary to Dental Extraction

• Chang KC

Abstract

PURPOSE
We report a case of orbital cellulitis with subperiosteal abscess secondary to dental extraction.
CASE SUMMARY
A 55-year-old man presented to the emergency department with severe erythematous, painful swelling of the left periorbital area and the upper cheek after extraction of the left maxillary molar and premolar teeth. Computed tomography scan demonstrated marked periorbital inflammation and medial displacement of the left lateral rectus muscle by subperiosteal abscess extending along the lateral orbital wall. After a 10-day course of intravenous broad spectrum antibiotics and a 7-day course of oral prednisolone, he achieved complete resolution of all clinical symptoms and signs.
CONCLUSIONS
Physicians should keep in mind that orbital complications may occur after oral surgery. A high level of suspicion in a patient with preceptal signs and a history of recent tooth infection or extraction is needed to avoid missing a diagnosis.

Keyword

Dental; Odontogenic; Orbital cellulitis; Subperiosteal abscess

MeSH Terms

Abscess
Anti-Bacterial Agents
Bicuspid
Cheek
Displacement (Psychology)
Emergencies
Humans
Inflammation
Middle Aged
Molar
Muscles
Orbit
Orbital Cellulitis
Prednisolone
Surgery, Oral
Tooth
Anti-Bacterial Agents
Prednisolone

Figure

• 

  Figure 1. Odontogenic orbital cellulitis in a 55-year-old man with the route of spread via the soft tissue of the cheek. (A, B) CT scans demonstrate medial displacement of the left lateral rectus muscle by a subperiosteal abscess that extends along the lateral orbital wall (*), results from spread of infection via rim-enhancing subperiosteal abscess (arrowheads) and the premalar soft tissue to the periorbital region (arrows). (C) CT scan shows an abscess (*) of premaxillary soft tissue (arrows) at upper cheek. (D, E, F) Two weeks after treatment, CT scans demonstrate the resolution of subperiosteal abscess of the lateral orbital wall and periorbital soft tissue involvement.

Reference

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