The use of standardized orbital ultrasound in the diagnosis of sinus induced infections of the orbit in children: a preliminary report

Infections of the orbit in children usually present as a complication of si nusitis and may result in blindness or even death. Orbital cellulitis (OC) and subperiosteal abscess (SPA) represent different pathologies within the spectrum of orbital infections. The differentiation between OC and SPA is i mportant, since it implies two different therapeutic modalities. While SPA is usually treated by incision and drainage and parenteral antibiotics, OC may be treated with antibiotics alone. Contrast enhanced CT scan is commonl y used in the diagnosis of orbital infections, but does not always prove ac curate in differentiating between these two conditions. MRI is superior to CT in the resolution of soft tissue pathology and may be more precise in su ch situations, but is less available imaging tool outside North America and Europe. There have been a few reports in the early 1980's on the use of st andardized orbital ultrasound (SOU) in these two conditions. We have used S OU in seven children with sinus induced orbital infections-four with SPA an d three with OC. We reviewed our experience in these patients and compared the imaging characteristics of OC and SPA on SOU with those of conventional imaging modalities, used in orbital infections. In four of the cases, CT s can was inconclusive, while SUO was diagnostic. In this preliminary report. we conclude that SOU may be useful in the diagnosis of orbital infections. (C) 1999 Elsevier Science Ireland Ltd. All rights reserved.