Sinusitis with Subperiosteal Orbital Abscess
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This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0318-Sinusitis with Subperiosteal Orbital Abscess
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CA0318-Sinusitis with Subperiosteal Orbital Abscess
Case ReportHistory
Exam
Prior Study
Findings
Nasal Cavity and Nasolacrimal Drainage System
There is mucoperiosteal thickening in the nasal cavity more on the left side.
Sinuses
There is soft tissue swelling as part of the generalized, left-sided preseptal cellulitis and facial cellulitis. There is mucoperiosteal thickening in the sinuses.
There is bone erosion along the walls at the expected position of the anterior ethmoid artery between the ethmoid bone, as it forms the medial orbital wall, and the lacrimal bone.
Orbits & Eyes
There is very extensive preseptal periorbital and facial soft tissue swelling. There is extensive edema in the extraconal orbital fat. There is bone erosion along the medial wall of the orbit as described previously with a subperiosteal abscess extending from the expected position of the anterior ethmoid artery as far posteriorly as the expected position of the posterior ethmoid artery.
There is extensive edema likely vascular congestion throughout the intraconal compartment including some of the extraocular muscles. The superior or inferior ophthalmic veins are minimally dilated but not thrombosed.
There is proptosis with stretching of the optic nerve but no tenting of the globe posteriorly; this represents early tension orbit. The intraconal soft tissue swelling extends to the posterior uveal scleral margin but the globe itself does not appear to be involved.
Intracranial
There is no evidence of intracranial complications. There is no epidural or subdural empyema. There is no brain edema or abnormal meningeal enhancement. There is no evidence of cavernous sinus or other venous thrombosis.
Developmental variants
The sinuses are normally developed with the patient’s age without significant variation.
