A Rare Case of Orbital Cellulitis Followed by Therapeutic(Orthodontic) Extraction

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. © 2011, Association of Oral and Maxillofacial Surgeons of India.