Intraoperative Findings of Extraocular Muscle Necrosis in Linear Orbital Trapdoor Fractures

Karthik, R.; Scott, C. Ronald; Narayanan, Vivek; Chandran, Saravanan; Gurram, Prashanthi

doi:10.1016/j.joms.2019.02.033

Cited by 5 publications

(15 citation statements)

References 21 publications

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“…The most frequent aetiologies of this type of orbital fracture in our study were similar to the literature (i.e., assault and sports injuries). In addition, consistent with numerous reports [11,13,17,18], the trauma aetiology generally did not involve road traffic accidents [15,18,20], or falls [8], which represent the main causes of maxillofacial fractures. In this study, direct trauma to the orbital region results from a medium-or low-speed impact (generally following an assault or collision with an opponent during a sporting event), which produce twofold more type 1b than type 1a fractures.…”

Section: Discussionsupporting

confidence: 84%

“…In this retrospective analysis of all pure orbital floor fractures surgically treated in our hospital, OFTFs were present in 6.3% of patients; this was similar to the rate reported by Takahashi et al [7]. This rare type of fracture mainly affects young adult males and boys in the second decade of life, according to published case reports [8][9][10][11][12][13][14][15][16], and case series [17][18][19][20][21], involving patients over 30 years of age (Table 4). The most frequent aetiologies of this type of orbital fracture in our study were similar to the literature (i.e., assault and sports injuries).…”

Section: Discussionsupporting

confidence: 82%

“…Several authors have stated that in patients with vertical eye movement restricted caused by entrapment of the inferior rectus muscle or peri-muscular connective tissue, surgical treatment of OFTFs should be performed as soon as possible to reduce the risk of permanent diplopia [2][3][4][5][6][7]. However, there is no universal consensus regarding the indications and timing of surgical treatment for rare OFTFs in adults, as indicated by various case reports [8][9][10][11][12][13][14][15][16], and case series (typically involving few patients) [17][18][19][20][21].…”

Section: Introductionmentioning

confidence: 99%

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Characteristics and surgical management of pure trapdoor fracture of the orbital floor in adults: a 15-year review

Gugliotta

Roccia

Garzino-Demo

et al. 2022

Oral Maxillofac Surg

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Purpose This retrospective study aims to define the optimal timing of the surgical treatment of orbital floor trapdoor fractures (OFTFs) in adults according to clinical and radiological findings. Methods From January 2006 to December 2020, 382 patients with isolated orbital floor fracture were admitted to the Division of Maxillofacial Surgery of Turin, Italy. The criteria for inclusion were age ≥ 16 years, preoperative computed tomography showing a linear (1a) or medial hinge fracture (1b), diplopia, and 6 months of follow-up data. Aetiology and mechanism of injury, presence of post-traumatic enophthalmos and oculocardiac reflex, time between trauma occurrence and surgery [stratified as < 24 h (urgent treatment), 24–96 h (early treatment), and > 96 h (late treatment)], days of hospitalisation, and clinical outcomes were examinated. Results Twenty-four patients (18 males; mean age, 23.2 years) presented with OFTFs. The most common cause was sport injury (50%). Type 1a fracture was observed in eight patients (mean age, 19.5 years), type 1b fracture in 16 patients (mean age, 23.6 years). Urgent, early, and late treatments were performed in eight patients each. The mean time between trauma occurrence and surgery was 3,8 days (range: 0–17 days). Resolution of diplopia was observed 1 week after surgery in 10 patients, 1 month in 12. Diplopia persisted in 2 patient, both treated > 96 h after trauma. Conclusion Although the number of patients was too small to define a standard protocol, the authors recommend early treatment of adult OFTFs to promote complete resolution of diplopia.

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Section: Discussionsupporting

confidence: 84%

Section: Discussionsupporting

confidence: 82%

Section: Introductionmentioning

confidence: 99%

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Characteristics and surgical management of pure trapdoor fracture of the orbital floor in adults: a 15-year review

Gugliotta

Roccia

Garzino-Demo

et al. 2022

Oral Maxillofac Surg

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“…15,16,[18][19][20][21][22][23] We found 11 previously reported cases of orbital trapdoor fracture with extraocular muscle entrapment (Table 2). [4][5][6][7][8][9][10][11][12][13] The mean age of our patients combined with the previously reported patients (16 patients) was 26.1 years. Since 12 out of 16 patients (75.0%) were male, [4][5][6][7][8][9][10][11][12][13] there is evidence of male predominance, similar to the other types of orbital fractures.…”

Section: Discussionmentioning

confidence: 86%

“…[4][5][6][7][8][9][10][11][12][13] The mean age of our patients combined with the previously reported patients (16 patients) was 26.1 years. Since 12 out of 16 patients (75.0%) were male, [4][5][6][7][8][9][10][11][12][13] there is evidence of male predominance, similar to the other types of orbital fractures. 24 The medial and inferior rectus muscles were entrapped in 5 and 11 patients in the combined the present and previous studies, respectively.…”

Section: Discussionmentioning

confidence: 86%

Orbital Trapdoor Fracture With Extraocular Muscle Entrapment in Adults: A Case Series

Miyazaki,

Someda,

Yokoyama

et al. 2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To report adult patients with an orbital trapdoor fracture with extraocular muscle entrapment. Methods: We retrospectively reviewed 566 adult patients (>18 years) with a pure orbital fracture who were referred to us from January 2016 to May 2023. The following data were collected: age, sex, affected side, causes of injury, concomitant ocular injury and nasal bone fracture, presence or absence of oculocardiac reflex and infraorbital nerve hypesthesia, period from injury to surgery, follow-up period, and pre- and postoperative limitation of extraocular muscle motility and fields of a binocular single vision. Results: We found 5 patients (0.9%) with an orbital trapdoor fracture with extraocular muscle entrapment (age range, 19–47 years; all males; 2 right and 3 left). Causes of injury included performing a bench press, fall, assault, boxing, and bicycle accident. Entrapment of the inferior and medial recti muscles was seen in 2 and 3 patients, respectively. None of the patients had any sign of oculocardiac reflex. After surgical reduction, the field of binocular single vision became normal in 3 patients and was incompletely recovered in 2 patients, in whom consultation with us was delayed. Conclusion: Adults with extraocular muscle entrapment may not present with an oculocardiac reflex. Urgent release of an entrapped muscle is, however, still recommended to avoid permanent limitation of extraocular muscle motility.

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Orbital Fractures in the Pediatric Population

Gooris,

Mourits,

Mensink

et al. 2023

Surgery in and Around the Orbit

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Intraoperative Findings of Extraocular Muscle Necrosis in Linear Orbital Trapdoor Fractures

Cited by 5 publications

References 21 publications

Characteristics and surgical management of pure trapdoor fracture of the orbital floor in adults: a 15-year review

Characteristics and surgical management of pure trapdoor fracture of the orbital floor in adults: a 15-year review

Orbital Trapdoor Fracture With Extraocular Muscle Entrapment in Adults: A Case Series

Orbital Fractures in the Pediatric Population

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