원저

항생제 치료로 완치된 안와 골막하농양 환자의 특징

송창은1, 이동희1,*, 전범조1, 정상희1, 김수환1, 조진희1, 윤희로1
Chang Eun Song1, Dong Hee Lee1,*, Beom Cho Jun1, Sang Hee Jung1, Soo Whan Kim1, Jin Hee Cho1, He Ro Yoon1
Author Information & Copyright
1가톨릭대학교 의과대학 이비인후과학교실
1Department of Otorhinolaryngology, College of Medicine, The Catholic University of Korea, Seoul, Korea
*교신저자: 조진희, 137-701 서울 서초구 반포동 505 가톨릭대학교 의과대학 이비인후과학교실 전화: (02) 590-2764·전송: (02) 593-1354 E-mail: entcho@catholic.ac.kr

© Copyright 2006 The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery. This is an Open-Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: May 27, 2006; Accepted: Jun 26, 2006

Published Online: May 31, 2020

ABSTRACT

Background and Objectives: Traditional therapeutic approach for orbital subperiosteal abscess secondary to acute sinusitis has been surgery when there is definite evidence of abscess radiologically. But there is increasing evidence that more cases have been managed nonsurgically with equal success. We hypothesized that patients who can be managed without surgery have identifiable features that may aid in predicting response to medical therapy. Materials and Method: Retrospective chart review was performed on twenty-three patients admitted betweeen 1993 and 2004 with orbital subperiosteal abscess identified on CT scan. Patients were divided into two groups: the first with successful management without surgery and the second who recieved surgery. Several parameters were compared between the two groups to identify the features that determine the therapeutic approach. Results: Fourteen patients were classified into the first group and nine in the second group. All patients in both groups were started with intravenous antibiotics and had serial ophthalmologic examinations. Statistical significance was noted in the following variables between the two groups (p<0.05): age (6.29 in the medical group vs. 16.7 in the surgical group), degree of proptosis and presense of ophthalmoplegia at presentation. All patients 10 years old or younger (n=13) were managed successfully without surgery, wheras 90% of patients 11 years old or older (n=10) needed surgery. Other variables such as sex, side of lesion, initial body temperature, WBC count, visual acuity at presentation, presense of chemosis, length of hospital stay and presense of complications showed no statistical difference between the two groups. Conclusion: An indivisualized therapeutic plan should be tailored for each patient with orbital subperiosteal abscess. An initial trial of intravenous antibiotics with close monitoring of visual acuity is appropriate especially in patients who are younger and have no gaze restriction at presentation. (J Clinical Otolaryngol 2006;17:99-105)

Keywords: 안와; 농양; 부비동염
Keywords: Orbit; Abscess; Sinusitis