Clinical Studies Of Children Of Periorbital And Orbital Cellulitis

Objective:To investigate children periorbital and orbital cellulitis (Children periorbital and orbital cellulitis), clinical features, imaging studies the characteristics and treatment.Methods:Kat sophomore Eye Hospital from January2007to January2012were13cases of periorbital and orbital cellulitis in children clinical data were retrospectively studied. Summary of the clinical features, imaging studies of the characteristics and treatment. Clinical features include:visual acuity, intraocular pressure, exophthalmos, eye position, movement, like the complex, the anterior segment and retinal chorioretinal situation. Imaging studies, including the B-mode ultrasound (brightness mode B ultrasound), computed tomography (computed tomography to CT), magnetic resonance imaging Magnetic resonance imaging (MRI),. Early full adequate doses of broad-spectrum antibiotics, if necessary, application of the impact of hormone therapy, intranasal endoscopic paranasal sinuses open drainage is the most effective treatment of periorbital and orbital cellulitis.Results:Periorbital and orbital cellulitis, decreased visual acuity in4cases; ipsilateral intraocular pressure is abnormal in5cases; exophthalmos ipsilateral eye compared to the prominence of9cases; benign epithelial tumors, patients do not meet the eye movement examination. Limited eye movement:One patient turn limited the movement of6cases of patients in all directions are limited,2cases of patients with a limited range of motion, corrected visual acuity greater than0.3and can meet the complex, like the patients examined were complex like check existence of diplopia;12cases of eye pain, conjunctival edema in7cases, one cases of retinal changes.Periorbital and orbital cellulitis imaging performance:B-ultrasonography:3patients showed soft tissue swelling of the lesion, ill-defined, internal heterogeneity showed diffuse echo weakened muscle stripes brighten, blur or not, more associated with the group flocculent slightly stronger echo.1case showed the soft tissue of the inflammatory lesions in the region, that is a strong echo of the entity, and liquefied area is no echo. CT:lesion distribution:In this study, the upper wall of three cases, three cases of the inner wall of the inferior wall of5cases,2cases of subperiosteal space infection.7patients had significantly shift the eye can be divided in accordance with the scope of inflammation involving the muscle cone, outside the muscle cone, subperiosteal, sclera and diffuse infection. Muscle vertebral infection in3cases,2cases of abscess mass effect within the muscle cone space abscess formation, show the ball round soft tissue density, uniform density, a clear boundary, CT scan showed low density, the boundary is still clear, oppression optic displacement, one cases after the injection of contrast agent-enhanced CT scan the perifocal showing strengthen. Muscle vertebra infection in three cases, the performance bar, flake soft tissue density, eye rectus muscle thickening, contour unclear. Subperiosteal infection in two cases, oval or spindle-shaped soft tissue density. Diffuse infection (5cases), orbital gap, both within and outside the muscle cone gap normal structure of the interface between the disappearance of the optic nerve, as unclear, exophthalmos, eye displacement, soft tissue density in the fat space. MRI manifestations:1patient underwent MRI examination in this study, MRI showed the abscess T1W1on display low signal T2W1was of high signal, the lesions are not enhanced.Treatment of periorbital and orbital cellulitis:Given broad-spectrum antibiotics in this group throughout the13patients admitted to hospital (ceftezole, per day per kilogram of body weight100mg intravenous infusion, symptoms, and three patients with concomitant administration of methylprednisolone pulse therapy with methylprednisolone per daykg of body weight1mg intravenously), suffering from eye to give the anti-inflammatory eye drops treatment. Seven patients given intranasal endoscopic paranasal sinuses open treatment of abscess formation at the same time, two patients due to the formation of abscess lesions of superficial skin incision drainage line. Technique to extract the pus were given the bacterial culture and susceptibility testing.9patients with pus, seven cases of uncultured bacterial growth,1case of Staphylococcus epidermidis,1case of Staphylococcus aureus.A treatment in patients with septic shock, depression and apathy, pale skin, pulse rate, immediately after admission to give anti-shock performance symptomatic treatment.Conclusion:Periorbital and orbital cellulitis with typical clinical features, and a preliminary diagnosis by clinical features. B ultrasound, CT, MRI, periorbital and orbital cellulitis differential diagnosis of significant value. Early full enough broad-spectrum antibiotics, if necessary, application of steroid pulse therapy, intranasal endoscopic paranasal sinuses open drainage technique is the most effective treatment of peri-orbital and orbital cellulitis.