Anterior Orbital Drainage of Subperiosteal Orbital Hematoma Associated with Chronic Paranasal Sinusitis: A Case Report

This study reports a middle-aged man with a subperiosteal orbital hematoma resulting from right side paranasal sinusitis, followed by progressive right eye ptosis, proptosis, restricted extraocular muscle motility, and elevated intraocular pressure. A right-sided subperiosteal hematoma abutting the superior medial wall of the right orbit and mucosal thickening in the paranasal sinuses and nasal cavities were identified using a computed tomography scan. We treated the patient with early surgical drainage via an anterior orbitotomy and successfully resolved the abovementioned conditions. Post-surgical imaging examination found no evidence of hepatoma recurrence. Paranasal sinusitis associated with a subperiosteal orbital hematoma leading to subacute proptosis is uncommon. Radio imaging, surgical exploration, and drainage help diagnose the problems earlier.

關鍵字

subperiosteal hematoma ； sinusitis ； orbit ； non-traumatic

並列摘要

本案例報告一位中年男性因慢性鼻竇炎導致右側眼窩骨膜下血腫，進而出現右側漸進性眼凸、眼瞼下垂、眼外肌活動限制及眼壓升高之症狀。經由電腦斷層影像檢查發現右側內上方眼窩的骨膜下血腫，以及副鼻竇及鼻竇之黏膜增厚。病患進而接受前眼窩探開術引流治療，上述症狀皆有明顯改善，且術後影像追蹤檢查並無血腫之復發。鼻竇炎所導致的眼窩骨膜下血腫在臨床上並不常見，安排影像檢查或者接受手術探查及引流皆有助於及早診斷此類案例。

並列關鍵字

骨膜下血腫；鼻竇炎；眼窩；非創傷性

參考文獻

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Aoki H, Tanaka Y, Niki Y, et al. Intraorbital subperiosteal hematoma due to paranasal mucocele--case report. Neurol Med Chir (Tokyo) 1997; 37(8): 627-9.

Whitlock JP, Bhatt AA, Stone JA. Subperiosteal orbital hematoma: An uncommon complication of acute sinusitis. J Clin Imaging Sci 2020; 10: 85.

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