A patient with a history of chronic pansinusitis and absence of midline nasal cavity structures due to chronic inhalational cocaine usage, presents with acute onset left-sided proptosis. She was found to have a non-traumatic, spontaneous subperiosteal orbital hematoma. The patient underwent left orbitotomy with hematoma drainage. Drainage revealed mostly blood with a small amount of purulence that grew MRSA when cultured. The patient received 4 weeks of intravenous antibiotics in addition to functional endoscopic sinus surgery. Fewer than 20 cases of subperiosteal orbital hematomas associated with chronic sinusitis have been reported. To our knowledge, this is the first reported case of a subperiosteal orbital hematoma associated with cocaine-induced midline destructive lesions.
Presentation Date: 01/05/2023
Issue Date: 01/13/2023