Orbital abscess as a complication of acute sinusitis: a case report.

Orbital complications are the most common complication of acute sinusitis and can determine a severe condition, leading to permanent blindness if not treated promptly and accurately. It is essential to be witting of and to suspect them to manage the complication in the fastest way possible and to minimize the patient’ risks. Prompt clinical evaluation and following medical treatment are fundamental but imaging (computed tomography [CT-scan] and magnetic resonance imaging [MRI]) plays a crucial role since it assesses the status of disease and the necessity of surgical intervention. In this case-report, we present a case of massive superior orbital abscess because of acute rhinosinusitis in a 23-year-old-young man who presented at our attention with an important left eye proptosis, diplopia, associated to severe pain and swelling of the left eyeball, just 3-days after medical treatment and endoscopic surgery performed elsewhere. Imaging (CT-scan and MRI) displayed a left orbital abscess and guide the urgency of the intervention. Due to patient’s important symptoms and therapeutic unresponsiveness, surgical management and revision were decided. The massive orbital abscess was drained combining external and endoscopic approach to the widening inflammatory tissue and sinus surgery, focusing on frontal sinus, was performed to remove the focus of infection. After surgical intervention, patient kept following medical treatment based on corticosteroids, local and systemic antibiotics. A rapid relief of the major symptoms was observed in the postoperative period and up to now, no recurrence occurred. This evidence confirms a correct transnasal endoscopic procedure performed in well-experienced hands could be the right solution.