Presentation
Headache and right orbital pain.
Patient Data
marked right maxillary, ethmoidal, and right frontal sinusitis associated with marked rarefaction of the right lamina papyracea with right orbital extraconal/subperiosteal collection
blurring of the right orbital extraconal fat planes, most pronounced along the medial aspect
mild swelling of the right medial rectus muscle
right proptosis
rarefaction of the right inter-ethmoidal septae
mild left maxillary and sphenoid sinusitis are also noted
marked right maxillary antrum, ethmoidal, and right frontal sinuses associated with right orbital extraconal/subperiosteal collection;the collection elicits intermediate T1 and high T2/STIR signal intensities with restricted diffusion (high DWI and low ADC signal)
blurring of the right orbital extraconal fat planes, most pronounced along the medial aspect
mild swelling of the right medial rectus muscle
right proptosis
Case Discussion
The subperiosteal abscess of the orbit occurs as a complication of adjacent infections, such as acute sinusitis (as seen in this case) or orbital cellulitis.
In cases of extensive sinusitis, complications should be carefully assessed, including bone erosion leading to:
extension to the frontal sinus superficially, resulting in Pott's puffy tumor
extension from the frontal or ethmoidal sinuses into the orbit, causing subperiosteal abscess of the orbit, as observed in this case
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