Management of superior XXXX .

@entity2694 @entity1 @entity12476 @entity10188
UNASSIGNED: A superior @entity2694 (SSPOA) is a collection of purulent material between the periorbit and the superior bony orbital wall, and is typically a @entity12476 . SSPOA is characteristically managed by classic external surgical drainage. The aim of our study was to assess the role of surgical intervention in SSPOA. A retrospective medical chart review of @entity1 diagnosed with SSPOA secondary to rhinosinusitis between the year 2005 and 2013 was conducted. Collected data included age, gender, co-morbidity, clinical presentation, prior antibiotic management, CT scans, surgical approach, outcome and complications. Six @entity1 were included in our study, three males and three females with a mean age of 22.8 (range 9-58). Two @entity1 were treated with @entity10188 for 3  days prior to admission. Only the youngest @entity1 with the smallest abscess responded successfully to conservative treatment, while the rest were managed surgically: three @entity1 were treated successfully by the endonasal endoscopic approach and two @entity1 were treated by utilizing the combined endonasal endoscopic and external approach. In @entity1 who underwent the combined approach, the abscess was located in a more antero-lateral position than those treated endonasal endoscopically only. The location of a SSPOA dictates the surgical approach. The most antero-lateral SSPOAs should be drained by the combined approach, while more posterior abscesses should be approached endoscopically. Furthermore, a small SSPOA is first to be reported to resolve with conservative treatment. Level 4 (case series).
