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Orbital Subperiosteal Abscess
Bronwyn E. Hamilton, MDH. Christian Davidson, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Orbital subperiosteal abscess (SPA)
              • Definitions

                • Purulent accumulation between bony orbital wall and orbital periosteum

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Imaging Recommendations

                        DIFFERENTIAL DIAGNOSIS

                          PATHOLOGY

                          • General Features

                            • Staging, Grading, & Classification

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Chorney SR et al: The role of endoscopic sinus surgery in children undergoing external drainage of non-medial subperiosteal orbital abscess. Am J Rhinol Allergy. 35(3):288-95, 2021
                                                2. Abtahi SMB et al: Non-medial infectious orbital cellulitis: etiology, causative organisms, radiologic findings, management and complications. J Ophthalmic Inflamm Infect. 10(1):22, 2020
                                                3. Adil EA et al: Pediatric subperiosteal abscess secondary to acute sinusitis: a systematic review and meta-analysis. Laryngoscope. 130(12):2906-12, 2020
                                                4. Danishyar A et al: Orbital cellulitis. StatPearls, 2020
                                                5. Dohlman JC et al: Subperiosteal masqueraders as compared to subperiosteal abscess: contrasting clinical presentation and radiographic densities. Ophthalmic Plast Reconstr Surg. 36(6):596-600, 2020
                                                6. Geusens J et al: Subperiosteal orbital abscess from odontogenic origin: a case report. Int J Surg Case Rep. 73:263-7, 2020
                                                7. Cossack MT et al: Radiographic course of medically managed pediatric orbital subperiosteal abscesses. J Pediatr Ophthalmol Strabismus. 55(6):387-92, 2018
                                                8. Gavriel H et al: Conservative management for subperiosteal orbital abscess in adults: a 20-year experience. Ann Otol Rhinol Laryngol. 127(3):162-6, 2018
                                                9. Jabarin B et al: Indicators for imaging in periorbital cellulitis secondary to rhinosinusitis. Eur Arch Otorhinolaryngol. 275(4):943-8, 2018
                                                10. Quintanilla-Dieck L et al: Characteristics of superior orbital subperiosteal abscesses in children. Laryngoscope. 127(3):735-40, 2017
                                                11. Marchiano E et al: Characteristics of patients treated for orbital cellulitis: an analysis of inpatient data. Laryngoscope. 126(3):554-9, 2016
                                                12. Erickson BP et al: Orbital cellulitis and subperiosteal abscess: a 5-year outcomes analysis. Orbit. 34(3):115-20, 2015
                                                13. Liao JC et al: Subperiosteal abscess of the orbit: evolving pathogens and the therapeutic protocol. Ophthalmology. 122(3):639-47, 2015
                                                14. Le TD et al: The effect of adding orbital computed tomography findings to the Chandler criteria for classifying pediatric orbital cellulitis in predicting which patients will require surgical intervention. J AAPOS. 18(3):271-7, 2014
                                                15. Smith JM et al: Predicting the need for surgical intervention in pediatric orbital cellulitis. Am J Ophthalmol. 158(2):387-94.e1, 2014
                                                16. Emmett Hurley P et al: Subperiosteal abscess of the orbit: duration of intravenous antibiotic therapy in nonsurgical cases. Ophthal Plast Reconstr Surg. 28(1):22-6, 2012
                                                17. Todman MS et al: Medical management versus surgical intervention of pediatric orbital cellulitis: the importance of subperiosteal abscess volume as a new criterion. Ophthal Plast Reconstr Surg. 27(4):255-9, 2011
                                                18. Migirov L et al: Endoscopic sinus surgery for medial orbital subperiosteal abscess in children. J Otolaryngol Head Neck Surg. 38(4):504-8, 2009
                                                19. Sepahdari AR et al: MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging. AJR Am J Roentgenol. 193(3):W244-50, 2009
                                                20. Vairaktaris E et al: Orbital cellulitis, orbital subperiosteal and intraorbital abscess: report of three cases and review of the literature. J Craniomaxillofac Surg. 37(3):132-6, 2009
                                                21. McIntosh D et al: Failure of contrast enhanced computed tomography scans to identify an orbital abscess. The benefit of magnetic resonance imaging. J Laryngol Otol. 122(6):639-40, 2008
                                                22. Tanna N et al: Surgical treatment of subperiosteal orbital abscess. Arch Otolaryngol Head Neck Surg. 134(7):764-7, 2008
                                                23. Rahbar R et al: Management of orbital subperiosteal abscess in children. Arch Otolaryngol Head Neck Surg. 127(3):281-6, 2001
                                                24. Curtin HD et al: Extension to the orbit from paraorbital disease. The sinuses. Radiol Clin North Am. 36(6):1201-13, xi, 1998
                                                25. Patt BS et al: Blindness resulting from orbital complications of sinusitis. Otolaryngol Head Neck Surg. 104(6):789-95, 1991
                                                26. Chandler JR et al: The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 80(9):1414-28, 1970
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Orbital subperiosteal abscess (SPA)
                                                            • Definitions

                                                              • Purulent accumulation between bony orbital wall and orbital periosteum

                                                            IMAGING

                                                            • General Features

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Imaging Recommendations

                                                                      DIFFERENTIAL DIAGNOSIS

                                                                        PATHOLOGY

                                                                        • General Features

                                                                          • Staging, Grading, & Classification

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Chorney SR et al: The role of endoscopic sinus surgery in children undergoing external drainage of non-medial subperiosteal orbital abscess. Am J Rhinol Allergy. 35(3):288-95, 2021
                                                                                              2. Abtahi SMB et al: Non-medial infectious orbital cellulitis: etiology, causative organisms, radiologic findings, management and complications. J Ophthalmic Inflamm Infect. 10(1):22, 2020
                                                                                              3. Adil EA et al: Pediatric subperiosteal abscess secondary to acute sinusitis: a systematic review and meta-analysis. Laryngoscope. 130(12):2906-12, 2020
                                                                                              4. Danishyar A et al: Orbital cellulitis. StatPearls, 2020
                                                                                              5. Dohlman JC et al: Subperiosteal masqueraders as compared to subperiosteal abscess: contrasting clinical presentation and radiographic densities. Ophthalmic Plast Reconstr Surg. 36(6):596-600, 2020
                                                                                              6. Geusens J et al: Subperiosteal orbital abscess from odontogenic origin: a case report. Int J Surg Case Rep. 73:263-7, 2020
                                                                                              7. Cossack MT et al: Radiographic course of medically managed pediatric orbital subperiosteal abscesses. J Pediatr Ophthalmol Strabismus. 55(6):387-92, 2018
                                                                                              8. Gavriel H et al: Conservative management for subperiosteal orbital abscess in adults: a 20-year experience. Ann Otol Rhinol Laryngol. 127(3):162-6, 2018
                                                                                              9. Jabarin B et al: Indicators for imaging in periorbital cellulitis secondary to rhinosinusitis. Eur Arch Otorhinolaryngol. 275(4):943-8, 2018
                                                                                              10. Quintanilla-Dieck L et al: Characteristics of superior orbital subperiosteal abscesses in children. Laryngoscope. 127(3):735-40, 2017
                                                                                              11. Marchiano E et al: Characteristics of patients treated for orbital cellulitis: an analysis of inpatient data. Laryngoscope. 126(3):554-9, 2016
                                                                                              12. Erickson BP et al: Orbital cellulitis and subperiosteal abscess: a 5-year outcomes analysis. Orbit. 34(3):115-20, 2015
                                                                                              13. Liao JC et al: Subperiosteal abscess of the orbit: evolving pathogens and the therapeutic protocol. Ophthalmology. 122(3):639-47, 2015
                                                                                              14. Le TD et al: The effect of adding orbital computed tomography findings to the Chandler criteria for classifying pediatric orbital cellulitis in predicting which patients will require surgical intervention. J AAPOS. 18(3):271-7, 2014
                                                                                              15. Smith JM et al: Predicting the need for surgical intervention in pediatric orbital cellulitis. Am J Ophthalmol. 158(2):387-94.e1, 2014
                                                                                              16. Emmett Hurley P et al: Subperiosteal abscess of the orbit: duration of intravenous antibiotic therapy in nonsurgical cases. Ophthal Plast Reconstr Surg. 28(1):22-6, 2012
                                                                                              17. Todman MS et al: Medical management versus surgical intervention of pediatric orbital cellulitis: the importance of subperiosteal abscess volume as a new criterion. Ophthal Plast Reconstr Surg. 27(4):255-9, 2011
                                                                                              18. Migirov L et al: Endoscopic sinus surgery for medial orbital subperiosteal abscess in children. J Otolaryngol Head Neck Surg. 38(4):504-8, 2009
                                                                                              19. Sepahdari AR et al: MRI of orbital cellulitis and orbital abscess: the role of diffusion-weighted imaging. AJR Am J Roentgenol. 193(3):W244-50, 2009
                                                                                              20. Vairaktaris E et al: Orbital cellulitis, orbital subperiosteal and intraorbital abscess: report of three cases and review of the literature. J Craniomaxillofac Surg. 37(3):132-6, 2009
                                                                                              21. McIntosh D et al: Failure of contrast enhanced computed tomography scans to identify an orbital abscess. The benefit of magnetic resonance imaging. J Laryngol Otol. 122(6):639-40, 2008
                                                                                              22. Tanna N et al: Surgical treatment of subperiosteal orbital abscess. Arch Otolaryngol Head Neck Surg. 134(7):764-7, 2008
                                                                                              23. Rahbar R et al: Management of orbital subperiosteal abscess in children. Arch Otolaryngol Head Neck Surg. 127(3):281-6, 2001
                                                                                              24. Curtin HD et al: Extension to the orbit from paraorbital disease. The sinuses. Radiol Clin North Am. 36(6):1201-13, xi, 1998
                                                                                              25. Patt BS et al: Blindness resulting from orbital complications of sinusitis. Otolaryngol Head Neck Surg. 104(6):789-95, 1991
                                                                                              26. Chandler JR et al: The pathogenesis of orbital complications in acute sinusitis. Laryngoscope. 80(9):1414-28, 1970