Odontogenic orbital inflammation

Abstract

Objective: This study aimed to determine the most frequent clinical aspects in patients with odontogenic orbital inflammation, the computed tomography (CT) aspect, and the most appropriate treatment. Material and Methods: This is a retrospective case-series study conducted on 3 patients with ages between 16 and 55 years old, in the Ophthalmology and Oro-Maxillo-Facial Clinics of “Sf. Spiridon” Emergency Hospital, Iași, Romania. The following investigations were performed in all selected cases: visual acuity (VA), ocular motility examination, anterior segment examination at slit-lamp, fundus examination, intraoral clinical examination, sinus and orbital involvement on CT scan, pathogens involved. Results: All three patients presented swelling of the genic and periorbital regions, conjunctival chemosis, hyperemia of the conjunctiva, proptosis, pain, decreased vision and extraocular movement restriction. The CT examination identified orbital and periorbital cellulitis and ethmoidal expanded maxillary sinusitis or pansinusitis. Dental extraction, transalveolar drainage and orbital decompression were performed in all three cases. The evolution was favorable with remission of proptosis, edema of the genic and periorbital regions and conjunctival chemosis. Visual acuity remained poor in one case due to total optic nerve atrophy. Conclusions: Our study had a small number of patients, but the data was pertinent to ophthalmologists and maxillofacial surgeons who need to be aware of typical clinical features and the most common etiologies. Late treatment of dental infections can lead to severe ocular manifestations such as orbital cellulitis. Odontogenic orbital inflammation management involves a long-term and multidisciplinary approach. Abbreviations: CT = computed tomography, VA = visual acuity, CBCT = cone beam computed tomography, TED = thyroid eye disease, MRI = magnetic resonance imaging, OOC = odontogenic orbital cellulitis, RAPD = relative afferent pupillary defect

Periodontitis and Subsequent Risk of Cataract: Results From Real-World Practice

“…Second, oral microbiome from periodontitis can cause immune responses to exacerbate cataractogenesis. Some observations implied periodontitisinduced systemic inflammation and oxidative stress in the pathogenesis of eye diseases (15,26,27). That is, periodontal microbiota may trigger immune dysfunction in the oro-opticnetwork and promote the development of cataract.…”

Odontogenic orbital cellulitis. Case report and review of literature

“…In most cases it is the consequence of an up-per respiratory infection with H. influenza, Pneumococcus, Staphylococcus, Streptococcus spp. Odontogenic orbital cellulitis is a rare and severe cause of orbital infection and is associated with high risk of vision loss (2).…”

“…The most commonly used therapeutic combinations are vancomycin (15 to 20 mg/kg per day IV every 8 to 12 hours) + second or third generation cephalosporins (Ceftriaxone 2 g per day IV) + metronidazole (500 mg IV or orally every 8 hours) (1,2,(16)(17)(18). In case of cephalosporin allergy, fluoroquinolones may be used (Ciprofloxacin 400 mg IV twice a day, levofloxacin 500 mg IV twice a day).…”

“…In adults, the causes of orbital cellulitis are trauma, orbital foreign body retention, eye surgery, dacryocystitis, while in chil-dren sinusitis accounts for about 90% of the etiology. In adult population, the frequency of orbital complications from sinus infection ranges from 0.5% to 3.9%, and that of odontogenic orbital inflammation is even more infrequent (1)(2)(3).…”

Resolución Quirúrgica para Un Caso de Polisinusitis de Origen Odontogénico

“…La mayoría de los casos reportados presentan un pronóstico favorable en relación al tratamiento, asociado a una terapia antibiótica o drenaje quirúrgico (Youssef et al, 2008). Sin embargo, en algunos casos, pueden haber complicaciones como midriasis de la pupila, pérdida visual parcial , o parálisis de músculos extraoculares (Costan et al, 2020).…”