Wydanie 4/2011
str. 118

Infekcje zębopochodne a choroby narządu wzroku – przegląd literatury

Odontogenic Infections of the Orbit – a Literature Review

Ewelina Lachowicz1, Monika Modrzejewska1, Danuta Karczewicz1, Grażyna Wilk2

1 Katedra i Klinika Okulistyki Pomorskiego Uniwersytetu Medycznego w Szczecinie
  Samodzielny Publiczny Szpital Kliniczny nr 2 w Szczecinie
  Kierownik: dr hab. n. med. Wojciech Lubiński, prof. nadzw. PUM, FEBO
2 Katedra i Zakład Radiologii Ogólnej i Stomatologicznej Pomorskiego Uniwersytetu Medycznego w Szczecinie
  Samodzielny Publiczny Szpital kliniczny nr 2 w Szczecinie
  Kierownik: prof. dr hab. n. med. Grażyna Wilk

Summary: Nowadays dental diseases are a serious social and health problem. Human endodontic and periodontal infections are associated with complex of oral microfloras. These infections are predominantly anaerobic, with gram-negative rods being the most common isolates. A variety of chronic inflammation and clinical procedures may cause translocation of microorganisms from the oral cavity to the bloodstream. Bacteriemia can be a potential danger, leading most commonly to systemic complications. The extension of an orofacial infection to the maxillary sinus and orbit can result in significant morbidity and mortality especially in adults. Orbital cellulitis and a post septal abscess secondary to odontogenic infection are the most common complications. Uveitis and endophthalmitis may also occur the dental diseases course. The main symptoms of orbital infection are pain, swelling, chemosis, proptosis, diplopia, restricted eye movement. Decreased vision or blindness may also occur as a result of septic optic neuritis, cavernous sinus thrombosis, scleritis or episcleritis. Cerebral abscess, meningitis are rare but potential complications.
CT is the best method of investigation when orbital infections are suspected. CT preoperatively will guide the surgical approach and allow monitoring of orbital condition. In acute cases orbital ultrasound can also be used to determine the presence of an orbital abscess or endophthalmitis.
Antibiotic therapy for mixed infections must necessarily take into account their complex nature. Initially, antibiotics may be administered, but if no improvement appears within 48h, surgical drainage of the orbit and the affected sinuses must be performed.
Multidisciplinary medical care is necessary during the treatment of eye disease because of possible complications. Periodontal and endodontic therapy, neurological consultation should be included as an additional element of ophthalmological therapy.

Słowa kluczowe: zapalenie zębopochodne, infekcje przyzębia, powikłania okulistyczne.

Keywords: odontogenic infection, periodontitis, ocular complications.