The spread of inflammation from adjacent tissues, particularly infections originating from the sinuses, can lead to orbital periostitis. Acute cases are often caused by bacterial infections, while chronic cases are typically due to subcutaneous nodules, syphilis, or injuries.

bubble_chart Clinical Manifestations

There is a localized pain, especially worse at night, and the pain intensifies upon touch, accompanied by headache and elevated body temperature.

Sign: It is classified based on whether it occurs at the edge or deep within the orbit.

Anterior orbital periostitis: Eyelid and bulbar conjunctival congestion, edema, the eyeball often deviates to the opposite side, movement is restricted, there is significant tenderness at the orbital rim, and in advanced stages of inflammation, it may spontaneously rupture, with pus draining out leading to self-healing. Or it may recur and form a fistula, and in severe cases, it may combine to form cicatricial ectropion.

Posterior orbital periostitis: The eyeball protrudes forward, and if the lesion is at the apex of the orbit, it presents as superior orbital fissure or orbital apex syndrome, drooping of the upper eyelid (blepharoptosis), the eyeball is fixed and cannot move, the pupil is dilated, the light reflex is lost, and even visual impairment may occur. If it spreads backward into the cranial cavity, it may complicate into meningitis or cerebral edema, endangering life.

bubble_chart Treatment Measures

The primary treatment involves addressing the disease cause, administering systemic broad-spectrum antibiotics, and applying corticosteroids if necessary. Local physiotherapy or hot compresses can be used in conjunction. For cases with suppuration, incision and pus drainage may be performed. Deep-seated fluid accumulation requires the placement of drainage strips. If a fistula has formed and persists without healing, there may be residual dead bone, which should be surgically removed after controlling the acute inflammation.