Literature Review to create Evidence Based Care Pathway for Isolated Adult Orbital Blowout Fractures

Wood, Jessica; Adeoye, Joanne

doi:10.1080/09273972.2021.1914686

Cited by 4 publications

(2 citation statements)

References 20 publications

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“…The culprit lesion for symptoms was considered to be the microfracture fragment and, thus, surgery was necessary. Surgical treatment was performed on an elective basis, which followed the usual treatment policy for the BOF [ 12 , 15 ]. There are various approaches to the inferior orbital wall, including transmaxillary sinus, transconjunctival, and percutaneous approaches.…”

Section: Discussionmentioning

confidence: 99%

Pure Orbital Floor Blow-In Fracture: An Extremely Rare Case

Akiyama,

Ouchi,

Hosokawa

et al. 2024

Cureus

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A 57-year-old man presented with left diplopia on an upward gaze and ophthalmalgia after hitting the left side of his head. CT revealed a fracture on the left side of the orbital floor without orbital rim fractures and the protrusion of a small bone fragment into the orbit. Hess charts indicated markedly limited vertical movement of the left eye. Based on these findings, the patient was diagnosed with a pure orbital floor blow-in fracture (BIF). Symptoms persisted after a two-week monitoring period; therefore, the bone fragment was removed by a transcutaneous surgical approach with the assistance of a navigation system and an endoscope. Symptoms resolved after surgery, and CT and Hess examinations six months after surgery showed a good outcome. A pure BIF is rare, particularly on the orbital floor. Only a few similar case reports have been published to date, and we herein describe the surgical procedures performed and the treatment outcome of our case.

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Section: Discussionmentioning

confidence: 99%

Pure Orbital Floor Blow-In Fracture: An Extremely Rare Case

Akiyama,

Ouchi,

Hosokawa

et al. 2024

Cureus

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“…Orbital blowout fractures (BOFs) are quite common in maxillofacial trauma, mainly due to physical assault, and recently, there have been many occurrences of orbital BOFs due to traffic accidents or sports. [1,2] Fractures occur mainly at the lamina papyracea and at the floor of the infraorbital groove, which is the thinnest point of the orbital wall, resulting in medial and inferior BOFs. [3] Medial BOFs are considered rarer pathological entities than inferior BOFs.…”

Section: Introductionmentioning

confidence: 99%

Nasal packing with Merocel in a glove finger after endoscopic endonasal reduction of medial blowout fracture

Kim

Lee

Lee³

et al. 2021

Medicine

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After endoscopic endonasal reduction (EER) for medial blowout fracture (BOF), nasal packing may be necessary for sustaining the reduced orbital contents. This study aimed to introduce a new packing technique using Merocel in a glove finger. We retrospectively reviewed 131 patients with a mean age of 42.2 years (range, 13–80 years), who underwent EER for medial BOF, followed by a postoperative nasal packing of Merocel in a glove finger, between March 2016 and December 2019. Sex, age, side and cause of trauma, pre-operative diplopia and enophthalmos, duration from the occurrence of trauma to surgery, postoperative diplopia, enophthalmos, complications like sinusitis, and revision surgery were evaluated. The most common cause of injury was physical assault in 47 cases and a fall or slip event in 34. Pre-operatively 22 patients had diplopia and 1 patient had enophthalmos. Mean duration after trauma to the surgery was 13.2 days (range, 1–29 days). The mean operative time was 34.1 minutes (range, 10–70 minutes). Four weeks after operation, the nasal packing was removed at an outpatient clinic, with minimal pain, discomfort, and bleeding and no evidence of infection or inflammation. A computed tomography scan performed at 3 months postoperatively showed no re-bulging. The computed tomography image of 1 patient showed frontal sinus haziness; the patient had a headache and underwent endoscopic sinus surgery for symptomatic relief. Three patients had diplopia and 1 had enophthalmos at final follow-up. No other major postoperative complications were noted. Merocel in a glove finger packing technique proved itself to be safe and effective after EER for medial BOF.

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Isolated Orbital Fracture – Treatment and Outcomes in a Single Tertiary Care Centre

Maunula,

Blomgren,

Sinkkonen

et al. 2024

Craniomaxillofacial Trauma & Reconstruction

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Study Design Retrospective, questionnaire survey. Objective The literature lacks a consensus on treatment of isolated orbital fracture. Our aim was to explore treatment schemes and outcomes of patients with isolated orbital fracture treated at a single tertiary care centre. Methods We performed a retrospective chart review and a cross-sectional questionnaire survey. We reviewed the medical records of all patients diagnosed with isolated orbital fracture at an outpatient referral clinic in an urban university hospital between 2010 and 2016. We included only patients with isolated inferior, medial, or inferomedial orbital fracture in the study cohort. We sent a questionnaire to these patients to assess the prevalence and severity of long-term symptoms. Results We included 246 patients in the study cohort, of which 96 (39%) were treated surgically and 150 (61%) non-surgically. Median time from injury to surgery was 11 days (range = 0–44, IQR = 8,15), and to sending the questionnaire 44 months (range = 16–93). The questionnaire was completed by 89 patients (36%), of whom 51 (57%) reported at least one mild long-term symptom, 24 (27%) at least one moderate long-term symptom, and 17 (19%) at least one severe long-term symptom. Conclusions Patients with isolated orbital fracture treated at our unit reported severe long-term symptoms more frequently than would have been expected based on earlier research. Patients at our unit were treated surgically more often than in other similar units, which suggests that surgical treatment may be chosen over non-surgical treatment unnecessarily often at our unit.

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Literature Review to create Evidence Based Care Pathway for Isolated Adult Orbital Blowout Fractures

Cited by 4 publications

References 20 publications

Pure Orbital Floor Blow-In Fracture: An Extremely Rare Case

Pure Orbital Floor Blow-In Fracture: An Extremely Rare Case

Nasal packing with Merocel in a glove finger after endoscopic endonasal reduction of medial blowout fracture

Isolated Orbital Fracture – Treatment and Outcomes in a Single Tertiary Care Centre

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