인공 삽입물을 이용한 안와골절 수술 후 급성으로 발생한 안와농양 1예

정상문,임재석,박도훈,곽주영.Sang Moon Jeong. M.D.. Jae Seok Yim. M.D.. Do Hoon Park. M.D.. Ju Yeong Kwak. M.D. 대한안과학회 2007 대한안과학회지 Vol.48 No.12

Purpose: To report a case of acute orbital abscess after Medpor? implantation for orbital floor fracture repair. Case summary: A 15-year-old boy who was punched in the right orbit visited our clinic because of diplopia. An orbital CT scan demonstrated a fracture of the right orbital floor. At surgery, a Medpor sheet was placed over the orbital floor defect. Over the first three days, clinical improvement was gradual, but at four days postoperatively, depression of the right eye was restricted, and lower lid edema and proptosis was present in the right eye. At eight days postoperatively, the orbital CT scan showed a large cystic mass surrounding the Medpor sheet and fine needle aspiration cytology showed a number of inflammatory cells. Because systemic antibiotics were ineffective, the Medpo? sheet and the cystic mass were removed through a transconjunctival approach to the orbit. A culture of the removed Medpor? sheet grew Staphylococcus aureus and signs of inflammatory cells in the tissue were present. After removal of the abscess, most clinical symptoms showed improvement except for the remaining depression of the right eye. Conclusions: Symptoms of eye movement restriction, lower lid edema, and proptosis may be uncommon after orbital floor fracture repair but can occur. We should also consider the possibility of abscess formation due to infection of the implant and emphasize the importance of prompt diagnosis and treatment of such a case.

상악 대구치 치성감염으로 인한 안와농양: 증례보고

진수영,김수관,문성용,오지수,김문섭,박진주,정미애,양석진,정종원,김정선,Jin, Soo-Young,Kim, Su-Gwan,Moon, Seong-Yong,Oh, Ji-Su,Kim, Moon-Seob,Park, Jin-Ju,Jeong, Mi-Ae,Yang, Seok-Jin,Jung, Jong-Won,Kim, Jeong-Sun 대한악안면성형재건외과학회 2011 Maxillofacial Plastic Reconstructive Surgery Vol.33 No.5

Orbital infection is typically caused by spread of inflammation from the paranasal sinuses. Less common causes can be skin infections, trauma, and hematogenous spread from other infections located elsewhere in the body. Odontogenic orbital infections account for 2~5% of all orbital infections, and occur as a result of periodontitis, odontogenic abscess from caries, tooth extraction, and oral surgery. Orbital infections can be divided into preseptal infection, orbital subperiosteal abscess, orbital abscess, and postorbital abscess. Symptoms which can be observed are swelling of the eyelids and erythema, orbital edema, displacement of the eyeball, exophthalmos, ophthalmoplegia, and even impairment of the optic nerve. Here we present the case of a patient who had an orbital abscess secondary to an abscess of the right maxillary third molar. Rapid recovery occurred following surgical treatment and antibiotic therapy. In addition a brief review of the literature is included.

안와연조직염 및 안와농양의 수술적 치료 후 진단된 급성눈물주머니염 1예

허민구,윤종명,곽미선 대한안과학회 2019 대한안과학회지 Vol.60 No.1

Purpose: We report a case of acute dacryocystitis diagnosed with abscess and rupture of lacrimal sac and fistula to posterior orbit during the operation. Case summary: A 71-year-old woman visited our clinic with edema and pain in the eyelid from three days ago. For past four months, there was viscous of the left eye and tears. The patient had severe conjunctival chemosis and hyperemia, compared with the left eyelid edema and redness. Orbital CT scan showed orbital cellulitis, which was followed by systemic antibiotics and steroid therapy. On the 4th day of therapy, orbital abscess formation was observed in orbit MRI and surgical drainage was planned. During surgery, we found rupture of the posterior part of lacrimal sac and fistula to posterior orbit. Pseudomonas aeruginosa was identified in the bacterial cultures, and after the administration of appropriate antibiotics, the disease showed improved progress, and then additional dacryocystorhinostomy was performed. Conclusions: In our case, acute dacryocystitis rarely spread in orbit, which may lead to delayed diagnosis, orbital cellulitis and abscess, resulting in serious complications of vision threat. So, we think that it is necessary to consider surgical treatment more actively in the stage of chronic dacryocysitis. 목적: 안와연조직염을 치료하던 중 경과 악화 및 안와농양이 합병되어 수술 중 발견된 눈물주머니의 농양 및 파열과 뒤쪽 안와로 형성된 샛길을 확인하고 급성 눈물주머니염을 진단하였기에 보고하고자 한다. 증례요약: 71세 여자 환자가 3일 전부터 발생한 눈꺼풀의 부종과 통증을 주소로 내원하였다. 좌안 눈꺼풀부종과 발적에 비해 심한 결막 부종 및 충혈 소견을 보였으며, 안와전산화단층촬영상 안와연조직염 소견이 관찰되어 전신 항생제 및 스테로이드 치료를 하였으나 경과가 악화되었다. 치료 4일째 안와 자기공명영상촬영에서 안와농양이 관찰되어 수술적 배농술을 계획하였고, 수술 중 눈물주머니의 농양과 눈물주머니 뒷부분의 파열 및 안와로 형성된 샛길을 확인하였다. 세균배양검사상 녹농균이 동정되어 적절한 항생제 투여후 호전되었으며, 이후 눈물주머니코안연결술을 시행하였다. 결론: 본 증례와 같이 급성 눈물주머니염이 드물게 안와쪽으로 진행하는 경우에는 진단이 늦어지고 안와연조직염 및 안와농양이 합병되어 시력위협의 중대한 합병증이 발생할 수 있으므로 만성 눈물주머니염 단계에서 보다 적극적으로 수술적 치료를 고려하는 것이 필요하다고 생각된다.

골막하 농양을 동반한 심한 안와연조직염의 치료로서 고용량 스테로이드 병용요법의 임상 효과

천현철,박정민,이진화,안희배,Hyun Chul Cheon,Jung Min Park,Jin Hwa Lee,Hee Bae Ahn 대한안과학회 2006 대한안과학회지 Vol.47 No.12

Purpose: To investigate the effect of corticosteroids in the treatment of orbital cellulites with subperiosteal abscess. Methods: The medical records of 4 patients treated for orbital cellulitis with subperiosteal orbital abscess were reviewed. The class and dose of corticosteroids, surgical drainage, treatment course and clinical outcomes were reviewed. Results: All patients received corticosteroids showed satisfactory results during 4.5 months of average follow up. Only one patient have been decreased visual acuity. Complications were minimal including mild hypokalemia, increased hepatic enzyme including aspartate aminotransferase and alanine aminotransferase. Conclusions: The use of corticosteroids may be beneficial in the treatment of orbital cellulitis with subperiosteal abscess.

내시경 부비동 수술 후 발생한 시력 손실이 동반된 안와 기종 1예

박준완,정종인 대한이비인후과학회 부산,울산,경남 지부회 2017 임상이비인후과 Vol.28 No.2

Orbital complications following endoscopic sinus surgery are rare but may lead to serious morbidity, because the paranasal sinuses are adjacent to the orbit. Orbital complications following blindness are mostly caused by direct injury of orbital contents such as optic nerve, extraocular muscles, and its blood supply. And it also progress rapidly. We report a case of orbital emphysema with visual loss after endoscopic sinus surgery without direct damage of orbital contents.

Use of the facial dismasking flap approach for surgical treatment of a multifocal craniofacial abscess

Ishii, Yoshitaka,Yano, Tomoyuki,Ito, Osamu Korean Society of Plastic and Reconstructive Surge 2018 Archives of Plastic Surgery Vol.45 No.3

The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient's life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

Use of the facial dismasking flap approach for surgical treatment of a multifocal craniofacial abscess

Yoshitaka Ishii,Tomoyuki Yano,Osamu Ito 대한성형외과학회 2018 Archives of Plastic Surgery Vol.45 No.3

The decision of which surgical approach to use for the treatment of a multifocal craniofacial abscess is still a controversial matter. A failure to control disease progress in the craniofacial region can potentially put the patient’s life at risk. Therefore, understanding the various ways to approach the craniofacial region helps surgeons to obtain satisfactory results in such cases. In this report, we describe a patient who visited the emergency department with a large swelling in his right cheek. A blood test and computed tomography revealed odontogenic maxillary sinusitis. The patient developed sepsis due to a progressive multifocal abscess. An abscess was seen in the temporal muscle, infratemporal fossa, and interorbital region. To control this multifocal abscess, we used the facial dismasking flap (FDF) approach. After debridement using the FDF approach, we succeeded in obtaining sufficient drainage of the abscess, and the patient recovered from sepsis. The advantages of the FDF approach are that it provides a wide surgical field, extending from the parietal region to the mid-facial region, and that it leaves no aesthetically displeasing scars on the face. The FDF approach may be one of the best options to approach multifocal abscesses in the craniofacial region.

심경부 감염에 속발한 안와 봉와직염 1예

이동욱,정지성,유승재,배일헌 대한이비인후과학회 2006 대한이비인후과학회지 두경부외과학 Vol.49 No.1

Orbital cellulitis implies acute suppurative inflammation involving anterior and posterior portion of orbital septum. In most cases, these are either extended from adjacent dermal cellulitis or paranasal sinusitis according to the anatomic characteristics of orbit. The authors experienced a unique case of deep neck infection, which was immediately followed by orbital cellulitis without paranasal sinusitis. The patient was treated with aggressive antibiotics without any problems. The authors report the case with literature review. (Korean J Otolaryngol 2006;49:118-21)

A Case of Orbital Abscess following Porous Orbital Implant Infection

( Seung Woo Hong ),( Ji Sun Paik ),( So Youl Kim ),( Suk Woo Yang ) 대한안과학회 2006 Korean Journal of Ophthalmology Vol.20 No.4

Purpose: We present a case of orbital abscess following porous orbital implant infection in a 73-year-old woman with rheumatoid arthritis. Methods: Just one month after a seemingly uncomplicated enucleation and porous polyethylene (Medporⓡ) orbital implant surgery, implant exposure developed with profuse pus discharge. The patient was unresponsive to implant removal and MRI confirmed the presence of an orbital pus pocket. Despite extirpation of the four rectus muscles, inflammatory granulation debridement and abscess drainage, another new pus pocket developed. Results: After partial orbital exenteration, the wound finally healed well without any additional abscess formation. Conclusions: A patient who has risk factors for delayed wound healing must be examined thoroughly and extreme care such as exenteration must be taken if there is persistent infection.

A Case of an Orbital Abscess Managed by Endonasal Endoscopic Surgery

Jin, Hong-Ryul,Shin, See-Ok Korean Rhinologic Society 1998 Journal of rhinology Vol.5 No.2