Edema with periostitis

With periostitis of antritis origin, edema andinfiltration of soft tissues mainly captures the lower eyelid, chemosis is limited to the mucous membrane of the lower eyelid, extending more to the inner corner of the eye, less often - passes to the upper eyelid. In cases of purulent periostitis, with more pronounced manifestations, limitation of mobility of the eyeball downwards and its displacement upward are observed.

Periostitis with frontis in children occurs onlyin the older age, while sometimes expressed in a slight puffiness and swelling of the soft tissues of the anterior and orbital frontal sinus walls. The skin in this area is pasty, painful on palpation, there is a thickening of the periosteum. The swelling in the future goes to the eyelid, often there is a shift of the eyeball down.

The development of subperiostal (periorbital)abscess in children can occur extremely quickly, in some cases, the onset of an abscess is observed already on the 2nd - 3rd day of sinus disease. In view of the anatomical features of the structure of the orbital tissues, as a rule, the spread of pus does not take place inside the orbit, but from the outside, often manifesting as a fistulous course, the localization of which depends on the affected sinus. Initially, the subperiosteal abscess, which is often located in the upper medial corner of the orbit, is characterized by swelling and reddening of the eyelid, more than the upper one.

Soon, opening the eye becomes impossible,the mobility of the lobe is sharply limited, chemosis occurs, and sometimes exophthalmos. Fluctuation. as a rule, is not found for a long time, since the abscess can be located in the depth of the orbit; In addition, palpation is prevented by significant tension of the tissues and swelling of the skin.

The localization of the periorbital abscess becomesClearly clear after fistula formation. In case of inflammation of the sinuses of the latticed bone, in the case of a breakthrough in the subperiosteal abscess, the fistula is usually located above the median ligament of the eyelids, with the disease of the maxillary sinus in the lower orbital margin, and at the frontins the opening of the periorbital abscess occurs through the soft tissues on the inferior frontal sinus wall.

Abscesses of eyelids and fistulas of the eyelidare a manifestation of purulent inflammation of the soft tissues of the orbit, and they can be in the form of independent complications or a consequence of other intraorbital complications.

Children often have common severemanifestations of the disease with a high rise in body temperature, intoxication, pronounced weakness, headache and pain in the area of ​​the affected eye. Localized marked swelling and inflammatory infiltration of eyelids and conjunctiva.

The eye gap in most sick children is closed,may occur chemosis. With the expansion of the optic cleft, normal mobility of the eyeball is observed. Collateral edema and inflammatory infiltration often seize and the side wall of the nose at its base.

All of the above creates the impression of a difficult situation, and the condition of such patients can be regarded as much more severe than it actually is.


"Inflammation of the paranasal sinuses in children,
M.Ya. Kozlov

Symptomatology of orbital complications with sinusitisin children is very diverse and depends on both the prevalence and severity of the complication, and on the localization of the main process, sinus involvement. In addition to what has been said, the symptomatology and course.

The onset of a retrobulbar abscess is,as a rule, a consequence of a purulent lesion of the paranasal sinuses, predominantly the sinuses of the latticed bone, or gemi and pansinusitis. The development of the complication is accompanied by a pronounced.