Head and Neck Imaging

Abscess, subperiosteal orbital

collection of pus, typically localized between the periorbita and the medial orbital wall (lamina papyracea), as a complication of bacterial sinusitis. The formation of an abscess is preceded by inflammatory oedema (with preseptal cellulitis) and a subperiosteal phlegmon (Fig.1) (Fig.2). The sinusal infection spreads to the orbit via small veins or through the delicate lamina papyracea. The subperiosteal orbital abscess may eventually break through the periorbita and involve the orbital fat; this may be further complicated by ophthalmic vein thrombosis and cavernous sinus thrombosis.

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Fig.2

Ethmoiditis with subperiosteal rim-enhancing abscess (arrow) against the lamina papyracea, displacing the medial rectus muscle.
Abscess, subperiosteal orbital, Fig.1
Abscess, subperiosteal orbital, Fig.2