Subperiosteal Abscess Symptoms, Causes, Treatment, ICD-10 Code

An infection such as sinusitis or ethmoiditis can lead to the development of a condition known as a subperiosteal abscess. This illness is characterised by the accumulation of pus between the periorbital and the lamina papyracea. It is a well-described pathogenic process affecting the bones that sustain the structure. It is typically brought on by severe sinusitis of the ethmoid and maxillary complex. The eye's surrounding area may experience pain, edoema, and redness. Antibiotics are often used as a form of treatment, with possible surgical removal of the abscess.

In most cases, an enhanced CT scan is used to radiographically diagnose a subperiosteal abscess. Depending on the clinical appearance, this illness is normally managed with progressive intravenous antibiotic treatment, with or without surgical intervention. Traditionally, surgical drainage using endoscopic or external techniques has been used to treat subperiosteal orbital abscesses. Nonetheless, antibiotics alone can manage the vast majority of cases. A transnasal endoscopic technique can be used to safely and effectively treat an orbital SPA in certain patients.

Symptoms

Subperiosteal abscess is distinguished by face edoema, unilateral eye discomfort, and redness. Swelling and erythema are possible symptoms of both preseptal and orbital cellulitis. Fever is occasionally present. Endophthalmitis, cavernous sinus thrombosis, meningitis, cerebritis, brain abscess, and even death are all possible outcomes of an infection that has progressed retrogradely. Periorbital edema and proptosis are the primary clinical characteristics of orbital abscesses.

Causes

Acute sinusitis of the ethmoid and maxillary complex is the source of a subperiosteal abscess more often than any other cause. The progression or spreading of orbital cellulitis can lead to the formation of a subperiosteal abscess. This type of abscess can affect the ethmoid, frontal, or maxillary bones. Sinusitis, skin infections, bacterial septicemia, orbital/paranasal surgery, and other conditions can contribute to the development of orbital infections. Odontogenic infections are another potential source of subperiosteal orbital abscess. In a few rare instances, it may be brought on by hematogenous growth to the periosteal area.

Treatment

The therapy of a subperiosteal abscess normally consists of prospective treatment with intravenous antibiotics. Clinical improvement or abrupt visual compromise can determine whether or not surgical intervention is necessary. Despite radiographic indications of an SPA, several experts recommend an early trial of IV antibiotics. However, as there is no acknowledged standard of care for treating subperiosteal abscesses, each case should be handled individually.

The best way to treat a subperiosteal abscess is still up for debate; some healthcare professionals advocate for immediate surgical drainage, while others advise starting with medicinal treatment. Traditionally, external or endoscopic surgical drainage has been used to treat subperiosteal ocular abscesses. However, antibiotics alone can be effective for the vast majority of patients.

Subperiosteal Abscess ICD-10 code

Subperiosteal mastoid abscess is identified by the ICD-10 code H70.01. This number may be further specified to identify which ear is affected, such as H70.019 for unidentified ear or H70.013 for bilateral ears.