We report a rare case of
orbital cellulitis occurring secondary to a dental
infection followed by therapeutic (orthodontic) extraction. A 16 year old female patient presented to the dental office with a left orbital
proptosis for the past 4 days. PNS view, CT scan revealed an
abscess in relation to medial, lateral superior inferior walls of the orbit associated with naso ethmoidal and left maxillary sinus. Through nasal endoscopy, middle meatus antrostomy and ethmoidectomy was performed for the drainage of
pus from the orbit, ethmoid and maxillary sinus under
general anesthesia. Immediately regression of orbital swelling was noticed. Eyeball movements improved.
Epiphora reduced and
proptosis declined. With the advent of higher
antibiotics, orbital
infection rarely occurs secondary to dental causes except in a very few cases. Complete elimination of
pus from orbital cavity, para nasal air sinuses and appropriate
antibiotic coverage at the earliest forms the mainstay of treatment. The nasal endoscopic approach with orbital
decompression is the most acceptable atrumatic, cosmetic and functional procedure.