Extent of Resection of the Lamina Papyracea in Medial Subperiosteal Abscess

Abstract

Objective. To compare the surgical outcomes of minimal and wide resections of the lamina papyracea in cases with medial subperiosteal abscess.

Setting. University hospital.

Study Design. Case series and planned collection.

Materials and Methods. Thirteen patients with medial subperiosteal abscess as a complication of sinusitis were included in this study. All patients had reduced visual acuity and ophthalmoplegia. Each patient underwent endoscopic sinus surgery to treat the abscess. Age, sex, extent of lamina resection, postoperative vision status, ophthalmoplegia, and the return of orbit to its normal position were recorded.

Results. Eight (62%) and 5 (38%) patients underwent minimal and wide endoscopic lamina papyracea resection, respectively. Proptosis, visual acuity, and ophthalmoplegia returned to normal within 24 to 48 hours. All patients received medical treatment in the form of intravenous antibiotics and steroids. Neither technique required revision surgery.

Conclusion. Medial subperiosteal abscess is a serious medical condition that can lead to blindness. Endoscopic evacuation of the abscess is currently the treatment of choice. Minimal lamina papyracea resection may be sufficient to drain the abscess. It should be further evaluated as it may have the same result as wide lamina papyracea resection and wide exposure of the periorbit. The aim of the operation is to liberate the pus regardless of the extent of the resection. Revision surgery was not needed with either technique.