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This is a retrospective study looking at the clinical and treatment profiles of patients with orbital subperiosteal abscess (SPA) in an adolescent and adult population. SPA is rarer in this age group compared to a paediatric population (less than nine-years-old) and much of the literature regarding management focuses on children. This study had 76 patients with 12 in the nonsurgical treatment group and 64 in the surgical group. The median age in the nonsurgical group was 30 years, range 12-79, and in the surgical group was 41 years, range 16-60. The large difference in patient numbers between the two groups makes comparison somewhat difficult. The authors report that there is no significant difference in SPA volume between the two groups, unless the patient has sinusitis in which case SPA was significantly smaller in the nonsurgical compared to the surgical cohort. Interestingly, they also report that the length of hospitalisation is not statistically different in either group. They conclude that medial orbital location of SPA and absence of relative afferent pupillary defect may be strong indications for initial nonsurgical management, although further studies with a larger nonsurgical cohort would provide more conclusive evidence.

Orbital subperiosteal abscess: the role of nonsurgical management among adolescents and adults.
Li E, Chambers C, Amadi AJ, et al.
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Hetvi Bhatt

Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.

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