Eyelid and periorbital necrotizing fasciitis, a severe preseptal infection, a systemic review of the literature and anatomical illustrations

IF 1.8 3区医学 Q2 DENTISTRY, ORAL SURGERY & MEDICINE Journal of Stomatology Oral and Maxillofacial Surgery Pub Date : 2024-10-01 DOI:10.1016/j.jormas.2023.101498

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Abstract

In necrotizing fasciitis, aggressive surgical debridement and broad-spectrum antibiotics are the cornerstone of treatment but cannot be proposed for the eyelid and periorbital area because of the risk of blindness, eyeball exposure and disfiguration. The aim of this review was to determine the most effective management of this severe infection while preserving eye function. A literature search of the PubMed, Cochrane Library, ScienceDirect and Embase databases was conducted for all articles published up to March 2022; 53 patients were included.

Management was probabilistic, combining antibiotic therapy with skin (+/- orbicularis oculi muscle) debridement in 67.9% of cases, and probabilistic antibiotic therapy alone in 16.9% of cases. Radical surgery with exenteration was performed in 11.1% of patients; 20.9% of patients had complete loss of vision, and 9.4% died of the disease. Aggressive debridement was rarely necessary possibly because of the anatomical particularities of this region.

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眼睑和眶周坏死性筋膜炎--一种严重的睑板前感染，文献和解剖图解的系统回顾。

在坏死性筋膜炎中，积极的手术清创和广谱抗生素是治疗的基础，但由于眼睑和眶周区域存在失明、眼球暴露和毁容的风险，因此不能建议对其进行治疗。本综述旨在确定治疗这种严重感染的最有效方法，同时保护眼部功能。我们对 PubMed、Cochrane Library、ScienceDirect 和 Embase 数据库中截至 2022 年 3 月发表的所有文章进行了文献检索，共纳入 53 例患者。67.9%的病例采用概率性治疗，结合抗生素治疗和皮肤（+/-眼轮匝肌）清创，16.9%的病例仅采用概率性抗生素治疗。11.1%的患者接受了根治性手术和外展手术；20.9%的患者视力完全丧失，9.4%的患者死于该病。可能是由于该区域解剖结构的特殊性，很少需要进行积极的清创手术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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