Isolated fracture of the superior orbital fissure

Taylor, Kara; Mizen, Kelvin; Spencer, Nicholas

doi:10.1016/j.bjoms.2009.06.230

Cited by 7 publications

(4 citation statements)

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“…Наличие двух апертур -зрительного отвер-стия и верхней глазничной щели -определяет офтальмологическую картину в варианте синдро-мов верхней глазничной щели и вершины орбиты [13,24,40].…”

Section: Discussionunclassified

Penetrating cranial injury with giant intraorbital foreign body

Kasatkina

Михайловна²,

Nikolaenko

et al. 2016

Ophthalmology Reports

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гематомы и отёка век. При раскрытии глазной щели визуализировались хемоз бульбарной конъ-юнктивы, гипосфагма, спавшееся глазное ябло-ко, а также обширная рана роговицы, в которой, помимо фрагментов внутренних оболочек глаза, находилось гигантское инородное тело (корпус шариковой ручки) (рис. 1, A). Учитывая глубину залегания ранящего агента, амавроз и полную на-ружную офтальмоплегию, было выдвинуто пред-положение о наличии у пострадавшего синдрома вершины орбиты. При оценке неврологического статуса невро-патологом совместно с нейрохирургом очаговой патологии не выявлено.В связи с наличием в распоряжении врачебной бригады компьютерного томографа стандартное рентгенологическое исследование глазницы и па-раорбитальных структур не выполнялось.В ходе мультиспиральной компьютерной томо-графии (МСКТ) были получены отчётливые изо-бражения инородного тела вытянутой формы, состоящего из двух разных по форме и рентге- ВВЕДЕНИЕПроникающие ранения орбиты являются до-статочно редкой разновидностью травмы, встре-чающейся у молодых лиц обоего пола. Ещё реже данная патология осложняется проникновением ранящего агента в полость черепа, трансформи-руясь в краниоорбитальное повреждение (0,4 % от всех травм головы) [5,7,8,14,16,25,34,35,42]. В связи с этим анализ подобных клинических ситуаций представляет несомненный научный и практический интерес.Ниже представлено описание случая кранио-орбитального повреждения из нашей практики.Пациент Ш., 33 года, поступил в приёмное отделение СПбГБУЗ «ГМПБ № 2» 11 декабря 2015 г. с жалобами на слепоту правого глаза, отёк и кровоизлияние в толщу век. Со слов по-страдавшего, в конфликтной ситуации он полу-чил удар по глазу длинным твёрдым предметом с ограниченной следообразующей поверхностью. За медицинской помощью обратился немедленно.Острота зрения при поступлении равнялась нулю. Глазная щель сомкнута из-за умеренной * КЛИНИЧЕСКИЙ СЛУЧАЙ УДК 617.7

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Section: Discussionunclassified

Penetrating cranial injury with giant intraorbital foreign body

Kasatkina

Михайловна²,

Nikolaenko

et al. 2016

Ophthalmology Reports

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“…Although magnetic resonance set with greater fidelity the orbital apex, Computed Tomography (CT) should be used in the presence of damage to the orbital framework 8 . CT is important for diagnosis, particularly as regards the extent of the trauma, but without a clinical examination accurate it does not have much value.…”

Section: Discussionmentioning

confidence: 99%

Superior orbital fissure syndrome after facial trauma

Jardim¹,

Faverani²,

Masocatto³

et al. 2017

Arch Health Invest

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The superior orbital fissure is a crack that communicates with the middle cranial fossa and is located between the greater and lesser wings of the sphenoid in the posterior region of the orbit. It presents a close relationship with several important structures such as the optic foramen and II, III, IV, V and VI cranial nerve and the sphenoid and ethmoid sinuses. Zygomatic-orbital fracture may trauma in the posterior region of the orbit and may result in the Superior Orbital Fissure Syndrome (SOFS) or Apex Orbital Syndrome (AOS). The superior orbital fissure syndrome results from compression structures that pass this region, resulting in paralysis of the cranial nerves III, IV and VI. Clinically, the patient has ptosis, mydriasis and ophthalmoplegia, it is very important that the diagnosis is made before the surgical manipulation of reduction and fixation of zygomatic fracture. Case report: A male patient, 37, hit and run victim was survived by Trauma Surgery Team. Diagnosed with head trauma and diffuse axonal injury, it was transferred to the Intensive Care Unit (ICU) where he stayed for three weeks. It was conducted by the Oral and Maxillofacial Surgery and was diagnosed zygomaticomaxillary fracture type Le Fort III and mandibular fracture associated with SOFS. The surgical treatment of mandibular and zygomaticomaxillary fractures was conducted. The ptosis devolved and postoperative 6 months was noted complete remission of the syndrome signals. Descriptors: Craving; Optical Nerve; Syndrome; Cranial Nerve. ResumoA fissura orbitária superior é uma fenda que se comunica com a fossa craniana média e localiza-se entre as asas maior e menor do esfenoide na região posterior da órbita. Apresenta íntima relação com diversas estruturas nobres, como o forame óptico e os II, III, IV, V e VI pares cranianos e os seios esfenoidal e etmoidal. Fratura zigomático-orbitária pode desencadear trauma na região posterior da órbita, podendo resultar na Síndrome da Fissura Orbitária Superior (SFOS) ou na Síndrome do Ápice Orbitário (SAO). A síndrome da fissura orbitária superior é resultante da compressão de estruturas que passam nessa região, resultando na paralisia dos pares cranianos III, IV e VI. Clinicamente o paciente apresenta ptose palpebral, midríase e oftalmoplegia, sendo muito importante que o diagnóstico seja feito anteriormente a manipulação cirúrgica de redução e fixação da fratura de zigoma. Relato de caso: Paciente do gênero masculino, 37 anos, vítima de atropelamento, foi socorrido por Equipe de Cirurgia do Trauma. Com diagnóstico de traumatismo craniano e lesão axonal difusa, o mesmo foi transferido para Unidade de Terapia Intensiva (UTI) aonde permaneceu por 3 semanas. Foi reavaliado pela Cirurgia e Traumatologia Bucomaxilofacial e diagnosticou-se fratura zigomático-maxilar do Tipo Le fort III e fratura mandibular associado a SFOS. Realizou-se tratamento cirúrgico das fraturas mandibular e zigomático-maxilares. A ptose palpebral involuiu e no pós-operatório de 6 meses notou-se completa remissão dos sinais da...

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“…The superior orbital fissure is a small space that connects the middle cranial fossa and the orbit [ 1 2 3 ]. Many nerves including cranial nerves (III, IV, V, and VI), and vessels pass through this fissure [ 1 2 ]. The superior orbital fissure syndrome (SOFS) is a complex of impaired functions of the cranial nerves due to compression or disruption of the superior orbital fissure.…”

Section: Introductionmentioning

confidence: 99%

“…The superior orbital fissure syndrome (SOFS) is a complex of impaired functions of the cranial nerves due to compression or disruption of the superior orbital fissure. The SOFS may result from various causes that include inflammation, infection, neoplasm, iatrogenic/traumatic factors and vascular problems [ 1 3 4 ]. The SOFS has many clinical features including the loss of sensation over the forehead, edema in the periorbital region, proptosis, dilation of the pupil, ptosis, ophthalmoplegia, loss of the corneal reflex, loss of the direct light reflex and lacrimal hypo-secretion [ 1 2 3 4 ].…”

Section: Introductionmentioning

confidence: 99%

A Statistical Analysis of Superior Orbital Fissure Width in Korean Adults using Computed Tomography Scans

Park

Kim

2017

Arch Craniofac Surg

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BackgroundThe superior orbital fissure is a small area that connects the middle cranial fossa and the orbit. Many studies have measured the size of the superior orbital fissure. However, there is no standard value for the size of the superior orbital fissure. Therefore, we conducted this study to provide the average size of the superior orbital fissure in Korean adults.MethodsWe measured the widths of the superior orbital fissures of 142 patients using computed tomography scans. Because the width of the superior orbital fissure varies at different locations, we measured the superior orbital fissure width at the level of the optic canal.ResultsIn the males, the width of the superior orbital fissure on both sides was 3.79±0.93 mm, and these values were 3.79±0.96 mm for the left side and 3.783±0.92 mm for the right side. In the females, the widths of the superior orbital fissures were 3.62±1.35 mm on the left side, 3.69±1.18 mm on the right side, and 3.65±1.26 mm across both sides.ConclusionThere were no significant differences between the males and females or between the left and right sides. The present study suggests that we may accept the hypothesis that a congenitally narrow superior orbital fissure may be a risk factor for the superior orbital fissure syndrome. Surgeons should take precaution with patients who have narrow superior orbital fissures during the perioperative period.

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Isolated fracture of the superior orbital fissure

Cited by 7 publications

References 1 publication

Penetrating cranial injury with giant intraorbital foreign body

Penetrating cranial injury with giant intraorbital foreign body

Superior orbital fissure syndrome after facial trauma

A Statistical Analysis of Superior Orbital Fissure Width in Korean Adults using Computed Tomography Scans

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