Iatrogenic orbital cerebrospinal fluid leak in a young pediatric patient: Factors to consider

Area of Science:

• Ophthalmology
• Neurosurgery
• Pediatric Surgery

Background:

• Orbital and subperiosteal abscesses are pediatric conditions requiring surgical intervention.
• Orbital cerebrospinal fluid (CSF) leak is a rare but serious complication following abscess drainage procedures.
• Early recognition and management are crucial for favorable outcomes.

Purpose of the Study:

• To report a unique case of orbital CSF leak in a 5-month-old infant following transorbital abscess drainage.
• To describe the endoscopic repair of an orbital CSF leak.
• To emphasize the importance of surgical technique in preventing this complication.

Main Methods:

• A 5-month-old male infant underwent transorbital abscess drainage.
• A cerebrospinal fluid (CSF) leak was identified as a complication.
• Endoscopic repair of the dural defect was performed through the orbitotomy incision.

Main Results:

• The endoscopic repair of the orbital CSF leak was successful.
• No evidence of persistent leak was observed during follow-up.
• The surgical approach was implicated in the development of the complication.

Conclusions:

• Orbital CSF leaks, though rare, are significant complications of pediatric abscess drainage.
• Endoscopic techniques can be effective for repairing orbital CSF defects.
• Awareness of surgical considerations is vital to prevent orbital CSF leaks during abscess treatment.