ABSTRACT
Pott's puffy tumor (PPT) describes forehead swelling with associated frontal bone osteomyelitis and a subperiosteal abscess (SPA) requiring a high suspicion index for optimal outcomes. PPT is a life-threatening complication of frontal sinusitis typically found in adolescents. Our case is one of the youngest in the literature. This report describes a 3-year-old patient who developed multifocal abscesses in the epidural space with frontal and orbital SPA, requiring surgical intervention. Additionally, her course was complicated by a superior sagittal venous thrombosis, a complication commonly associated with PPT. We present an unusual case of orbital SPA and aim to highlight a life-threatening pediatric condition that is often underrecognized.
Subject(s)
Frontal Sinusitis , Orbital Cellulitis , Pott Puffy Tumor , Humans , Adolescent , Child , Female , Child, Preschool , Pott Puffy Tumor/complications , Pott Puffy Tumor/diagnosis , Abscess/complications , Abscess/diagnosis , Frontal Sinusitis/complications , Frontal Sinusitis/diagnosis , Orbital Cellulitis/complications , Edema/complicationsABSTRACT
The authors report a case of phakomatous choristoma presenting as an orbital tumor with involvement of the inferior oblique muscle. This is the only known case of this rare tumor directly invading and incorporating the inferior oblique. This tumor should be included in the differential of eyelid tumors and orbital tumors in infants. Finally, the authors review the histopathological and embryological characteristics of this lenticular tumor.
Subject(s)
Choristoma/diagnosis , Oculomotor Muscles , Orbit/diagnostic imaging , Orbital Diseases/diagnosis , Biopsy , Choristoma/congenital , Diagnosis, Differential , Female , Humans , Infant, Newborn , Orbital Diseases/congenital , Tomography, X-Ray ComputedABSTRACT
Postoperative eyelid infections are a rare complication of eyelid surgery. The authors present a case of an eyelid infection occurring within the first week following surgery in a patient taking etanercept--a biologic anti-TNF-α agent used in the treatment of rheumatoid arthritis. The authors urge caution regarding the use of steroid/antibiotic combination ointments and systemic steroids in patients undergoing elective eyelid surgery who are on such medications. Perioperative discontinuation of etanercept in consultation with the prescribing physician may also be considered. Eyelid infections following eyelid surgeries such as blepharoplasty and ptosis correction are uncommon.( 1 , 2 ) A review of a large series of blepharoplasty procedures estimated the rate of postoperative infection at 0.2%.( 3 ) However, patients who are relatively immunosuppressed may be at a higher risk of developing skin and eyelid infections. We present a case of postoperative infection in a patient who was taking etanercept (Enbrel, Immunex Corporation, Thousand Oaks, CA) for rheumatoid arthritis.
Subject(s)
Antirheumatic Agents/adverse effects , Blepharoplasty , Eyelid Diseases/chemically induced , Immunoglobulin G/adverse effects , Postoperative Complications/chemically induced , Staphylococcal Infections/chemically induced , Anti-Bacterial Agents/therapeutic use , Etanercept , Eyelid Diseases/diagnosis , Eyelid Diseases/drug therapy , Female , Humans , Middle Aged , Postoperative Complications/diagnosis , Postoperative Complications/drug therapy , Receptors, Tumor Necrosis Factor , Staphylococcal Infections/diagnosis , Staphylococcal Infections/drug therapy , Tomography, X-Ray ComputedABSTRACT
Dacryocystorhinostomy (DCR) is a procedure of choice for nasolacrimal duct obstruction and chronic dacryostenosis in the setting of patent canaliculi and a functional lacrimal pump. Two major approaches are utilized: external, via a transcutaneous incision and endonasal endoscopically guided. The surgery has a high success rate via both approaches. We review the history, evolution, current techniques, complications and future directions of DCR.
