Eur Arch Otorhinolaryngol (2017) 274:3549–3550 DOI 10.1007/s00405-017-4534-7 LETTER TO THE EDITOR ‘Conservative’ approach to periocular necrotising fasciitis with paranasal sinus involvement 1 1 1 Christopher Schulz · Mahesh Ramchandani · Ben Parkin Received: 22 February 2017 / Accepted: 14 March 2017 / Published online: 24 March 2017 © Springer-Verlag Berlin Heidelberg 2017 Dear Sir, tissue debridement was undertaken at this stage and the patient was transferred to an intensive care setting with We read with great interest the report written by Lim et al. intubation, sedation, continued antibiotics and inotropic entitled ‘Necrotising fasciitis of the paranasal sinuses’ . support. After 72 h, there was no evidence of further pro- It did, however, raise a point of contention, particularly in gression, and a very clear line of demarcation divided via- the context of a case we recently encountered. In the United ble and non-viable tissue. The area of necrosis appeared Kingdom, up to 30% of periorbital necrotising fasciitis is to correspond with the preseptal watershed area between managed conservatively, with outcomes comparable to the pretarsal vascular arcades of the upper eyelid and the cases treated more aggressively . Lim and colleagues orbital margin, with sparing of the supraorbital skin above, suggest that in the presence
European Archives of Oto-Rhino-Laryngology – Springer Journals
Published: Mar 24, 2017
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