Transnasal endoscopic surgery for orbital abscess

A 32 year female came to emergency department with left eye proptosis, nasal obstruction and headache .She had no vision and absent extra ocular movements in left eye .CT paranasal sinus showed left ethmoidal pyocele with orbital abscess. She was treated in private hospital with drugs and abscess drainage tried but abandoned due to excessive bleeding. She was admitted, evaluated and as in order to prevent impeding complication, she was taken up for trans nasal endoscopic orbital abscess drainage and CSF leak repair as an emergency procedure. About 5 ml pus drained. Vision and extra ocular movements improved. Hence, orbital complications of sinusitis should be intervened immediately to clear both sinus and orbital pathology. Transnasal endoscopic surgery is superior to external method to drain orbital abscess and sinus pathology with minimum morbidity by bidirectional method.