Superolateral Orbital Abscess Complicating Frontal Sinusitis - Need to Emphasize the External Approach

Background: Orbital abscess is an uncommon complication of rhinosinusitis especially involving the ethmoidal sinuses. It is commonly seen in children and drainage could be external, endoscopic or combined. Orbital abscesses complicating frontal sinusitis are uncommon.

Objective: Discuss the best route of drainage of superolateral orbital abscess complicating frontal sinusitis. Setting: Tertiary care urban referral hospital in a developing country.

Methods: 3 cases of orbital abscesses complicating frontal sinusitis, seen in an older pediatric male and two middle aged females are presented, and available literature reviewed. The peculiar challenges that their management posed especially regarding limitation of endoscopic approach are discussed.

Results: All cases had attempted endoscopic drainage and drainage via Lynch incisions that were abortive. Final route of successful drainage in the three cases was a superolateral brow incision. In all cases, drainage via superolateral brow incision combined with frontal sinus irrigation through trephining was successful.

Conclusion: Otolaryngologists need to be aware that superolateral orbital abscesses are best drained by external routes as endoscopic access to these abscesses is very limited.