Surgical outcomes of orbital trapdoor fracture in children and adolescents

Yang, Jae Wook; Woo, Jong Eun; An, Jae Hwan

doi:10.1016/j.jcms.2015.01.010

Cited by 23 publications

(26 citation statements)

References 14 publications

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“…However, in a delayed condition, the proportion of these symptoms was much lower. Yang et al 16 reported only 1/7 (14.3%) patients had vagal symptoms (nausea/vomiting) with an interval of more than 96 hours, compared with 80% in patients operated on within 24 hours. In this study, such symptoms happened in none of our patients with delayed surgery.…”

Section: Discussionmentioning

confidence: 97%

“…A long-term entrapment of extraocular muscle will cause insufficiency in the blood flow, and the resultant ischaemia will lead to fibrosis and muscular dysfunction, presenting as a high rate of persistent diplopia and restricted ocular mobility 4. Even after surgery to release the entrapment, the affected muscles still need a long time for recovery 16. Gerbino et al 6 included 15 paediatric patients with linear trapdoor fracture and muscular entrapment.…”

Section: Discussionmentioning

confidence: 99%

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Delayed surgical treatment of orbital trapdoor fracture in paediatric patients

Shen

et al. 2018

Br J Ophthalmol

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Long recovery time and a high percentage of persistent diplopia are the main problems of delayed trapdoor fracture in children. A prompt surgery within 48 hours is strongly recommended in patients with muscular entrapment even if an urgent treatment is hard to achieve. So are patients with soft-tissue entrapment and significant motility restriction. In the other patients without such indications, even though some recovery might be possible in the long term, a prompt surgery right after diagnosis is still preferable regardless of the entrapped contents.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 99%

Delayed surgical treatment of orbital trapdoor fracture in paediatric patients

Shen

et al. 2018

Br J Ophthalmol

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“…Soll and Poley [ 4 ] first referred to this phenomenon as “trapdoor fracture”. Large and comminuted fractures are more common in adults [ 5 ], whereas trapdoor fractures accompanied by soft tissue or muscle entrapment are more common in pediatric patients, because the facial bones of children are flexible and elastic due to incomplete mineralization [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

“…Pediatric orbital trapdoor fracture is often overlooked, as it is commonly accompanied by lack of external signs of trauma, and radiologic evidence may be minimal [ 1 ]. Especially, trapdoor fracture can be neglected in medial wall fractures because most trapdoor fractures occur in the orbital floor [ 2 ].…”

Section: Introductionmentioning

confidence: 99%

“…In reported cases of pediatric medial orbital wall trapdoor fracture, there was no significant bone displacement, but soft tissue herniation or rectus muscle incarceration were observed in most of cases [ 1 2 3 ]. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because CT findings did not indicate any evidence of a medial orbital wall fracture.…”

Section: Introductionmentioning

confidence: 99%

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Pediatric Orbital Medial Wall Trapdoor Fracture with Normal Computed Tomography Findings

Lee

Jung

Lee

et al. 2017

Arch Craniofac Surg

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With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

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