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Periorbital hematoma secondary to sinusitis in a child
1Department of Otolaryngology, Children's National Medical Center, Washington, DC 20010.
Insights
Subperiosteal hematoma, a rare complication of sinusitis in children, can cause proptosis and vision loss. Prompt surgical drainage is crucial for managing this orbital emergency.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Pediatric Surgery
Background:
- Periorbital abscess secondary to sinusitis is common in children.
- Subperiosteal hematoma is an exceptionally rare complication, with limited adult case reports.
- This condition requires prompt diagnosis and management to prevent vision loss.
Observation:
- A 4-year-old girl presented with sinusitis, proptosis, and reduced visual acuity.
- Computed tomography (CT) scan revealed findings suggestive of a periorbital mass.
- Surgical exploration identified a large organizing subperiosteal hematoma.
Findings:
- The subperiosteal hematoma was successfully drained surgically.
- This case highlights a rare pediatric presentation of subperiosteal hematoma.
- Early recognition is key to effective treatment.
Implications:
- Clinicians should consider subperiosteal hematoma in pediatric patients with acute proptosis and sinusitis.
- Prompt diagnosis and surgical intervention can preserve visual function.
- This rare entity underscores the importance of a comprehensive orbital assessment in pediatric sinusitis.
Abstract:
Periorbital abscess secondary to sinusitis is a well-recognized entity in children. However, subperiosteal hematoma is extremely rare and has been reported in only four adult patients. This article presents the case of a 4-year-old girl with sinusitis, proptosis, and decreased visual acuity. Surgical exploration of the orbit revealed the presence of a large organizing subperiosteal hematoma that was drained. The presence of a periorbital hematoma should be suspected in patients with acute onset of proptosis and findings of a periorbital mass and sinusitis on computed tomographic scan.