Origins and Management of Acquired Cutaneous Fistulae of the Orbit
Author: Ahsen Hussain
Base Hospital / Institution: NOSM University, Thunder Bay, Ontario, Canada
ePoster presentation
Abstract ID: 25-386
Purpose
The purpose of this review was to investigate the origins and management strategies of acquired cutaneous fistulae of the orbit.
Methods
Systematic Review
Results
Our search yielded 357 studies. After screening, 102 papers were chosen. Most papers were case reports or series (57) and retrospective studies (24).
A total of 471 fistula cases were reported. Cases were categorized by origin as iatrogenic (274), inflammatory and infectious (330), and trauma-related (10). Iatrogenic causes were: traumatic repair (38), implants (27), lateral canthoplasty (7), orbital exenteration (83), non-exenteration oncological surgery (26), radiotherapy (56), chemotherapy (2), other surgical procedures (35). Inflammatory and infectious causes were: dacryocystitis (308), Pott’s Puffy Tumour (8), other inflammatory conditions (10). Trauma-related causes were: direct trauma (6), foreign body reaction (2), substance use (2). A single case could fit into multiple categories.
Management strategies were reported in 451 cases. When attempted as primary management (95), conservative approaches had 80% of cases. Complete treatment failure was reported in 41 cases. CT and MRI were the primary imaging methods, particularly in fistulae involving the skull.
Conclusion
The most reported acquired fistulae were due to dacryocystitis. Most were amenable to DCR. Thorough history and physical examination are essential in approaching orbital cutaneous fistulae, as management strategies may vary greatly and impact success rate.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Edsel | Ing | Department of Ophthalmology & Visual Sciences, University of Alberta, Edmonton, Alberta, Canada |
| Arjav | Gupta | Department of Ophthalmology & Visual Sciences, Dalhousie University, Halifax, Nova Scotia, Canada |
