Clinical signs of orbital wall fractures as a function of anatomic location

Jank, Siegfried; Schuchter, Barbara; Emshoff, Rüdiger; Strobl, Heinrich; Koehler, Julius; Nicasi, A.; Norer, B; Baldissera, I.

doi:10.1016/s1079-2104(03)00317-2

Cited by 71 publications

(45 citation statements)

References 15 publications

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“…In our study, three patients (5 %) had neurosensory deficit, the value being low as compared to the studies of Ahmed et al (91.73 %) [26]. However our findings showed similar incidence as compared to the studies of Zingg et al (7.4 %) [27], and Larsen et al (7 %) [28]. We observed infraorbital nerve paresthesia in three patients, all of whom had sustained tripod fractures.…”

Section: Percentagesupporting

confidence: 66%

Ophthalmological Evaluation by a Maxillofacial Surgeon and an Ophthalmologist in Assessing the Damage to the Orbital Contents in Midfacial Fractures: A Prospective Study

Patil¹,

Kotwal²,

Joshi³

et al. 2015

J. Maxillofac. Oral Surg.

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Background and purpose Midfacial fractures may often be associated with injuries to the orbit which may lead to notable dysfunction of the visual apparatus, if not detected early after injury. The purpose of this study is to evaluate the associated ophthalmic injuries in mid-face trauma and to emphasize the need for understanding the ophthalmic signs and symptoms by an attending maxillofacial surgeon. Patients and methods A total number of 60 clinically and radiographically proven subjects with midfacial fractures were considered in the study that underwent complete ophthalmological evaluation at initial presentation. Referral to ophthalmologist was considered to determine the exact nature of injury and its implications. Results by a maxillofacial surgeon and ophthalmologist were evaluated. Results In our study, a male predominance with a mean age of 32 years was observed, with the most common etiology being Road Traffic Accidents. Forty-two of the 60 patients exhibited sub-conjunctival hemorrhage accounting for 70 % of ocular injuries recorded. While 28 of the 60 patients displayed peri-orbital edema (53.3 %), 8 patients experienced diplopia (13.32 %) and 8 patients showed relative afferent pupillary defect (13.32 %). Conclusion From our study, it becomes imperative that the maxillofacial surgeon should have a thorough knowledge of the various ophthalmic injuries that could occur in association with midfacial trauma in order to prevent visual complications to the patient. Understanding of the subtle injuries to the ocular apparatus which may be undiagnosed by a maxillofacial surgeon but have significant grave outcomes is essential.

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Section: Percentagesupporting

confidence: 66%

Ophthalmological Evaluation by a Maxillofacial Surgeon and an Ophthalmologist in Assessing the Damage to the Orbital Contents in Midfacial Fractures: A Prospective Study

Patil¹,

Kotwal²,

Joshi³

et al. 2015

J. Maxillofac. Oral Surg.

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“…It also provides attachment to the suspensory ligament of lockwood which supports the globe [6]. An inferiorly displaced fracture of the zygoma produces an antimongoloid slant and accentuation of the supratarsal fold of the upper eyelid and may result in disturbed ocular function, orbital shape and facial esthetics [1].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of two point rigid internal fixation in the management of zygomatic complex fracture

Chakranarayan

Thapliyal

Sinha

et al. 2009

J. Maxillofac. Oral Surg.

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Purpose To evaluate the efficacy of two point rigid internal fixation in the immobilization of zygomatic complex fractures. Patients and methods 30 patients with zygomatic complex fractures were managed by open reduction and internal fixation using titanium mini bone plate screws at the frontozygomatic and zygomatic buttress region. This prospective study was carried out at the Department of Oral & Maxillofacial Surgery, Armed Forces Medical College (AFMC), Pune, India between 1st August 2005 to 1st August 2007. Isolated unilateral zygomatic complex fractures of less than six weeks duration were included in the study. Result Clinically and radiologically satisfactory results were achieved in all 30 patients using two point rigid internal fixation at the frontozygomatic and zygomatic buttress region of zygomatic complex fracture. Conclusions Stable fixation and immobilization of isolated zygomatic complex can be achieved with two point fixation using titanium mini bone plate and screws at the frontozygomatic and zygomatic buttress region of zygomatic complex fracture. Postoperative complications like scarring, ectropion and neurological deficit can be avoided by not using infraorbital rim as the third point of fixation.

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“…Likewise, it has been found that conventional CT and ultrasonography are equally accurate in detecting fractures in the floor and medial wall of the orbit. 34,35 According to these facts, we decided to include cases with fractures in the orbital floor only.…”

Section: Discussionmentioning

confidence: 99%

A comparable study of the diagnostic performance of orbital ultrasonography and CBCT in patients with suspected orbital floor fractures

Johari‬¹,

Ghavimi²,

Mahmoudian³

et al. 2016

Dentomaxillofacial Radiology

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Objectives: To compare the diagnostic performance of ultrasonography and CBCT against CT in detecting orbital floor fractures. Methods: A total of 120 orbits with clinical suspicion of isolated orbital floor fractures underwent multislice CT scanning with coronal reconstruction; orbital ultrasonography using a standard machine equipped with a 7-to 10-MHz linear transducer; and CBCT. Patients with severe head and face injuries were not included. The diagnostic performance of ultrasonography and CBCT was reported assuming conventional CT as the imaging method of choice. Results: According to CT findings, fractures of the floor were present in 39 orbits. The sensitivity, specificity, positive-predictive value and negative-predictive value of ultrasonography in detecting orbital floor fractures were 87.2%, 100%, 100% and 94.2%, respectively. The corresponding values for CBCT were 97.4%, 97.5%, 95.0%, and 98.8%, respectively. Areas under the receiver operator characteristics curves of orbital floor fracture detection were 0.94 for ultrasonography and 0.98 for CBCT. Conclusions: When conventional CT cannot be performed in patients with clinically suspected orbital floor fracture and no severe or complex head and face injuries, CBCT could be used in detecting fractures as a reliable surrogate. Because of a lower sensitivity of ultrasonography, however, its use is limited in this regard.

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Clinical signs of orbital wall fractures as a function of anatomic location

Cited by 71 publications

References 15 publications

Ophthalmological Evaluation by a Maxillofacial Surgeon and an Ophthalmologist in Assessing the Damage to the Orbital Contents in Midfacial Fractures: A Prospective Study

Ophthalmological Evaluation by a Maxillofacial Surgeon and an Ophthalmologist in Assessing the Damage to the Orbital Contents in Midfacial Fractures: A Prospective Study

Efficacy of two point rigid internal fixation in the management of zygomatic complex fracture

A comparable study of the diagnostic performance of orbital ultrasonography and CBCT in patients with suspected orbital floor fractures

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