The role of early office-based needle aspiration in the management of subperiosteal hematoma.

Subperiosteal hematoma of the orbit is a rare complication that may occur in different situations. The most common cause is blunt trauma to the head region. The victims are usually young boys and the common site is usually orbital roof. There is no uniform approach in the literature in the management of subperiosteal hematoma. Conservative management has been recommended in cases with intact visual function. If conservative management is planned, complete resorption of hematoma may last several months, and the patients must tolerate diplopia and varying degrees of proptosis in this relatively long period of time. In this study, four boys (12-15 years) were referred to our clinic with a provisional diagnosis of subperiosteal hematoma after blunt trauma no more than 10 days after initial trauma. Although in our patients, no one had compressive optic neuropathy, they underwent hematoma aspiration and nearly 7 ml dark blood was drained. All procedures were performed in an office-based setting without local anesthesia or sedation and the patients tolerated the procedure comfortably and the procedure was uneventful. When there is no indication for orbitotomy in cases of subperiosteal hematoma, early office-based needle aspiration in comparison to follow-up or administration of steroid, is a viable approach because of its feasibility, an office-based treatment that obviates the need for general anesthesia and yields immediate recovery.