Importance: Orbital cellulitis with subperiosteal or orbital abscess can result in serious morbidity and mortality in children. Objective volume criterion measurement on cross-sectional imaging is a useful clinical tool to identify patients with abscess who may require surgical drainage.
Objective: To determine the predictive value of abscess volume and the optimal volume cut-point for surgical intervention.
Design: We conducted an observational cohort study using medical records from children hospitalized between 2009 and 2018.
Setting: Multicentre study using data from 6 children's hospitals.
Participants: Children were included if they were between 2 months and 18 years of age and hospitalized for an orbital infection with an abscess confirmed on cross-sectional imaging.
Exposure: Subperiosteal or orbital abscess volume.
Main Outcome And Measures: The primary outcome was surgical intervention, defined as subperiosteal and/or orbital abscess drainage. Multivariable logistic regression was performed to assess the association of abscess volume with surgery. To determine the optimal abscess volume cut-point, receiver operating characteristic (ROC) analysis was performed using the Youden Index to optimize sensitivity and specificity.
Results: Of the 150 participants (mean [SD] age, 8.5 [4.5] years), 68 (45.3%) underwent surgical intervention. On multivariable analysis, larger abscess volume and non-medial abscess location were associated with surgical intervention (abscess volume: adjusted odds ratio [aOR], 1.46; 95% CI, 1.11-1.93; abscess location: aOR, 3.46; 95% CI, 1.4-8.58). ROC analysis demonstrated an optimal abscess volume cut-point of 1.18 mL [AUC: 0.75 (95% CI 0.67-0.83) sensitivity: 66%; specificity: 79%]. CONCLUSIONS AND RELEVANCE: In this multicentre cohort study of 150 children with subperiosteal or orbital abscess, larger abscess volume and non-medial abscess location were significant predictors of surgical intervention. Children with abscesses >1.18 mL should be considered for surgery.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijporl.2023.111629 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Mean Platelet Volume as an Emerging Biomarker for Diagnosing Acute Appendicitis: A Retrospective Study.
Cureus
December 2024
General Surgery, Sri Devaraj Urs Medical College, Kolar, IND.
Introduction Acute appendicitis is a common surgical emergency that requires a timely and accurate diagnosis to prevent complications. Several laboratory markers have been assessed to improve the diagnostic accuracy of acute appendicitis, including C-reactive protein (CRP), white blood cell (WBC) count, and cytokines like interleukins and tumor necrosis factor-alpha. One less commonly used but potentially valuable marker is the mean platelet volume (MPV), which indicates the size of circulating platelets and has the potential to serve as a biomarker for inflammatory conditions.
View Article and Find Full Text PDF[Experience of transnasal endoscopic drainage of rhinosinusogenic frontal lobe abscess].
Vestn Otorinolaringol
December 2024
Surgut Clinical Traumatology Hospital, Surgut, Russia.
Unlabelled: Intracranial complications in inflammatory diseases of the ear and nose are currently not frequent, but their lethality remains high. The choice of optimal, safe and effective access in surgical treatment of purulent-inflammatory intracranial complications remains a subject of discussions and is based on an individual approach, depends on the volume, localization and clinical condition of the patient.
Objective: To demonstrate a clinical case of successful drainage of the brain frontal lobe abscess using endoscopic transnasal access under the control of the navigation system.
Operative caseload of general surgeons working in a rural hospital in Central Australia.
ANZ J Surg
December 2024
Department of Surgery, Alice Springs Hospital, Northwest Territories, Australia.
Background: There is limited published data on the caseload of general surgeons in Central Australia. The region has a significant Indigenous population, who often face higher rates of chronic diseases and require more frequent surgical interventions compared to non-Indigenous individuals. This study aims to outline the workload of surgeons at Alice Springs Hospital to determine the necessary skill set and surgical education for future surgeons.
View Article and Find Full Text PDFApplication of pedicle combined muscle flaps in treatment of chronic empyema with huge irregular abscess cavity after pulmonary surgery: a case report and literature review.
J Cardiothorac Surg
December 2024
Department of Cardiothoracic Surgery, Tongde Hospital of Zhejiang Province, Hangzhou, 310012, Zhejiang, China.
Article Synopsis
- - Chronic empyema, often complicated by bronchopleural fistula (BPF) and large abscess cavities, poses significant treatment challenges and can lead to severe health issues, including cachexia.
- - A 59-year-old male patient with a history of lung cancer developed empyema and BPF after chemotherapy, requiring surgical intervention due to persistent symptoms and poor drainage results.
- - Two-stage surgical treatment utilizing pedicled combined muscle flaps to repair and fill the irregular abscess cavity showed promising outcomes, improving the patient's condition and quality of life.
The Role of Neutrophil-to-Lymphocyte Ratio and Mean Platelet Volume in Diagnosing Odontogenic and Non-odontogenic Head and Neck Abscesses.
Cureus
October 2024
Clinic of Nephrology and Dialysis, University Hospital "St. Marina", Varna, BGR.
Introduction Head and neck abscesses are categorized as either odontogenic, originating from dental infections, or non-odontogenic, arising from soft tissue inflammation. This article aimed to investigate inflammatory markers, including the neutrophil-to-lymphocyte ratio (NLR) and mean platelet volume (MPV), and compare them against established diagnostic parameters such as white blood cell (WBC) count, neutrophil count (Neu), lymphocyte count (Ly), platelet count (PLT), C-reactive protein (CRP), and procalcitonin (PCT). Material and methods Our retrospective analysis of a prospective study involved 80 patients, including 50 individuals (56% men) with an average age of 41.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!