Subperiosteal Orbital Hematoma: An Uncommon Complication of Acute Sinusitis

Non-traumatic subperiosteal orbital hematoma is a rare finding and uncommon cause of proptosis. Reported cases describe an association with increased venous pressure. However, it is important to note that there is also an association with sinusitis, which must be differentiated from subperiosteal abscess. This article describes the unique imaging features of subperiosteal hematoma in the setting of sinusitis, as well as the suspected pathophysiology.

Pediatric posttraumatic orbital subperiosteal hematoma

AIM

To report five children with posttraumatic orbital subperiosteal hematoma.

METHODS

In this study, five cases with posttraumatic orbital subperiosteal hematoma were studied and reviewed along with similar cases in a systematic literature review.

RESULTS

The mean age of our patients was 9.40 ± 3.51 years, ranging from 4 to 13 years, and all were male. Mechanisms of injuries were blunt trauma, falling from a building, car accident, and falling from a bicycle. All patients had unilateral involvement. Treatment options included needle aspiration, surgical drainage, and observation for spontaneous resolution. Except for one patient, positive outcomes were achieved.

CONCLUSION

The most common location for posttraumatic orbital subperiosteal hematoma is the superior orbital wall. Traumatic optic neuropathy and permanent visual loss are uncommon. Observation, surgical drainage, and aspiration are common treatment options.

Subperiosteal haematoma of the orbit secondary to frontal sinusitis

Reported is the case of a 79-year-old woman initially diagnosed with periorbital abscess on the background of a recent upper respiratory tract infection. Unexpectedly, intraoperative findings were that of a haematoma rather than an abscess. Subperiosteal orbital haematoma (SOH) is an extremely rare complication of rhinosinusitis. In contrast to the more common periorbital abscess, it is seldom listed as a complication of sinusitis. A review of reported cases suggests an older patient demographic are affected by SOH in contrast to periorbital abscess which typically affects paediatric patients. Given current demographic trends toward an older patient population with multiple comorbidities, failure to consider SOH as a differential will have important implications on preoperative workup, perioperative care and final outcome for patients. We present this case as a reminder of a rare but important complication of a common disease.