Orbital Cellulitis With Subperisoteal Abscess Secondary to Dental Extraction

Cheol Chang Ki

doi:10.3341/jkos.2008.49.11.1845

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Ki: Orbital Cellulitis With Subperisoteal Abscess Secondary to Dental Extraction

Original Article

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

Published online: 7 September 2008

DOI: https://doi.org/10.3341/jkos.2008.49.11.1845

Orbital Cellulitis With Subperisoteal Abscess Secondary to Dental Extraction

Cheol Chang Ki, M.D.

Department of Ophthalmology, Dankook University College of Medicine, Cheonan, Korea

Address reprint requests to Ki Cheol Chang, M.D. Department of Ophthalmology, Dankook University College of Medicine #359 Manghangro Dongnam-gu, Cheonan-si, Chungnam 411-706, Korea Tel: 82-41-550-6490, Fax: 82-41-561-0137, E-mail: happyeye21@medimail.co.kr

Received 4 November 2008 Accepted 9 July 2008

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Dental, Odontogenic, Orbital cellulitis, Subperiosteal abscess

References

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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.

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