[Computed tomography in acute inflammation of the orbit]

Acute orbital infection, which is usually secondary to sinusitis, requires prompt diagnosis and timely treatment to prevent the infection from spreading and to avoid severe complications, such as osteomyelitis, orbital and cerebral abscesses, meningitis and cavernous sinus thrombophlebitis. Fifteen young patients with orbital cellulitis were examined: they were 13 men and 2 women, whose mean age was 23 years, with orbital cellulitis secondary to fronto-ethmoidal sinusitis (10 cases), to maxillary sinusitis (4 cases) and to craniofacial trauma (1 case). On the basis of CT findings the patients were divided into two groups according to whether the inflammatory process involved the preseptal (4 cases) or the postseptal (11 cases) space; postseptal cellulitis was classified as orbital cellulitis and subperiosteal abscesses. The site of the inflammatory process must always be accurately located because orbital septum integrity does affect treatment choice, which in our series was medical in preseptal cellulitis and always surgical in subperiosteal abscess. After describing the CT patterns of cellulitis and its possible complications, the authors emphasize the role of CT as the method of choice to confirm clinical diagnosis and to demonstrate the site, the extent and the complications of acute orbital cellulitis.