Valsalva-associated orbital compartment syndrome in the setting of frontoethmoidal mucocele and orbital cellulitis

Chad Y Lewis; Rupin N Parikh; Arnulfo Garza Reyes; Matthew R Hoffman; Erin M Shriver

doi:10.1080/01676830.2024.2355641

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Valsalva-associated orbital compartment syndrome in the setting of frontoethmoidal mucocele and orbital cellulitis

Journal article

Peer reviewed

Valsalva-associated orbital compartment syndrome in the setting of frontoethmoidal mucocele and orbital cellulitis

Chad Y Lewis, Rupin N Parikh, Arnulfo Garza Reyes, Matthew R Hoffman and Erin M Shriver

Orbit (Amsterdam), Vol.44(2), pp.211-214

03/04/2025

DOI: 10.1080/01676830.2024.2355641

PMID: 38815197

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Abstract

Valsalva-associated orbital compartment syndrome in the setting of orbital cellulitis, mucocele, or subperiosteal abscess has not been previously reported. A previously healthy girl presented with orbital cellulitis complicated by a subperiosteal abscess and frontoethmoidal mucocele. On the day of her planned orbitotomy and endoscopic sinus surgery, she developed a Valsalva-associated retrobulbar hemorrhage and elevated intraocular pressure after crying during a blood glucose fingerstick. An urgent canthotomy and cantholysis in addition to the planned endoscopic sinus procedure was performed. She did well post-operatively with normal vision at follow-up. Based on these experiences, there should be a consideration to implement heightened vigilance to prevent or minimize Valsalva maneuvers in orbital cellulitis patients with subperiosteal abscesses or mucoceles extending into the orbit. While it remains unclear whether and to what degree these patients may be at an increased risk of developing retrobulbar hemorrhage leading to orbital compartment syndrome, we hope that this novel report aids in providing another consideration with the goal of preventing vision loss.

orbital cellulitis

orbital compartment syndrome

subperiosteal abscess

mucocele

Valsalva-associated retrobulbar hemorrhage

Details

Title: Subtitle: Valsalva-associated orbital compartment syndrome in the setting of frontoethmoidal mucocele and orbital cellulitis
Creators: Chad Y Lewis - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
Rupin N Parikh - University of Iowa
Arnulfo Garza Reyes - Department of Ophthalmology and Visual Sciences, Carver College of Medicine, University of Iowa, Iowa City, Iowa, USA
Matthew R Hoffman - University of Iowa
Erin M Shriver - University of Iowa
Resource Type: Journal article
Publication Details: Orbit (Amsterdam), Vol.44(2), pp.211-214
DOI: 10.1080/01676830.2024.2355641
PMID: 38815197
eISSN: 1744-5108
Language: English
Electronic publication date: 05/30/2024
Date published: 03/04/2025
Academic Unit: Stead Family Department of Pediatrics; Otolaryngology; Ophthalmology and Visual Sciences
Record Identifier: 9984634947302771

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