|Year : 1982 | Volume
| Issue : 2 | Page : 111-112
Osteomyelits of the supra orbital margin
Eye Hospital Aligarh, India
Eye Hospital Aligarh
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Krishna G. Osteomyelits of the supra orbital margin. Indian J Ophthalmol 1982;30:111-2
Osteomyelitis of the Supra Orbital Margin is not a common condition. Osteomyelitis is usually present in children and young female adult under the age of 30 years. The common causes of supra orbital margin osteomyelitis ale trauma, and as a complication of chronic sinusitis. In majority of cases staphylococcus aureus was found responsible for this condition. Other bacteria such as Streptococcus Pneumoniae and Hemophilus influenzae are also the causative organism of the frontal bone osteomyelitis,,,
In the present case ptosis of the left upper lid associated with osteomyelitis of Supra Orbital Margin has been reported.
| Case report|| |
A 26 year married female R. S. reported with the complaints of drooping of the left upper lid for 12 months with a thick pus discharge from the upper lid sinus, following trauma of the left orbital margin by the stone. On examination of the left eye, there was sinus in the upper lid just below the junction of the medial 1 /3 and lateral 2/3 of the left supra orbital margins [Figure - 1]. There were granulation tissues at the mouth of the sinus. The adjacent area of sinus was tender.
The upper lid shows ptosis with restricted movements of levator palpebrae superioris. The extra ocular muscles show normal function. The upper bulbar and palpebral conjunctivae show chemosis and hyperemia.
The posterior segment of the eye ball was normal. The visual acuity was 6/6 in both eyes. The right eye was normal.
On laboratory investigation, the culture and sensitivity of the pus shows pseudomonas which was sensitive to Gentamicin (Garamycin).
The X-Rays of orbital margins shows sequestrum with destruction of adjacent bone in left supra orbital margin.
The patient was given injection of garamycin (160 mg. daily) for 10 days. After subsidence of inflammation and pus discharge the infected cavity was saucerized with the removal of sequestrum and subcutaneous tissue adhesion.
After 15 days, the levator palpebrae superioris starts regaining function and after 2 months the recovery of the ptosis is completed with normal functioning levator palpebrae superioris.
| Discussion|| |
Osteomyelitis of the supra orbital margin with sequestrum is not a common condition.
The mechanical ptosis in this case is due to the adhesions between the levator and subcutaneous tissue and pressure on the levator due to local oedema and inflammatory infiltrates.
The cases of mechanical ptosis, due to sinus disorders were reported by Dejean. Gazaniol and Wolff & Juler. In 1921 Comberg reported a case of mechanical ptosis due to inflammatory infiltrates.
The patient shows recovery with saucerization operation and antibiotic.
| Summary|| |
A case of the upper lid ptosis associated with traumatic osteomyelitis of supra orbital margin of the frontal bone has been reported.
| Acknowledgements|| |
I am thankful to Dr. Gyan Prakash, .E.N.T. Surgeon, Dr. S.K. Jain, consultant pathologist and Dr. Gyan P. Lal. consultant Radiologist for their help in this case.
| References|| |
Hall, T.S. and Colman, B.H., 1973, Diseases of the nose, throat and ear, E.L.B.S. and Churchill. Livingstone. Great Britain. 10th ed. p 96.
Montgomery, W., 1969, Disease of the nose, throat and ear Ed. Ballenger, JJ. Lea and Febiger, Philadelphia, 11th ed. p 173.
Rege, S.R., Shah, K.L. and Kantawala, S.A., 1972, Ind. J. Ophthalmol. Vol. No. 3, Sept., p 96.
Stewait, J.P. ed, 19E8, Longan Turner's Diseases of the nose, throat and ear, Varghese India. 7th ed. p 106.
Dejean, 1927, Cited by Duke Elder, 1952, Text Book of Ophthalmology, Vol. V. Henry Kimptom, London, p 5137.
Gazaniol, 1929, Cited by Duke Eider 1952, Text Book of Ophthalmology, Vol. V, Henry Kimptom, London, p 5137.
Wolff and Juler, 1932, Cited by Duke Elder, 1952, Text Bcok of Ophthalmology, Vol. V, Henry Kimptom, London, p 5137.
Comberg, 1921, cited by Duke Elder, 1952, Text Book of Ophthalmology, V, Henry Kimptom, London, p 5137.
[Figure - 1]