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Dos Santos JC, Gorla LFDO, Moreno R, Monnazzi MS, Pereira Filho VA, Gabrielli MFR, Gabrielli MAC. Traumatic Orbital Compression Syndromes: A Comprehensive Study Into Etiologies, Intervention Strategies, and Clinical Outcomes. J Craniofac Surg 2024:00001665-990000000-01683. [PMID: 38838361 DOI: 10.1097/scs.0000000000010375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 05/06/2024] [Indexed: 06/07/2024] Open
Abstract
Facial fractures and their historical link to potential blindness have been well-documented, often attributed to optic canal injuries or retinal vascular occlusion. This dire consequence can result from both direct and indirect ocular trauma, including retrobulbar hemorrhage. Traumatic orbital compression can manifest in various forms, such as hematomas, fractured bone fragments, and emphysema, all posing a significant threat to vision, necessitating immediate intervention. In this study, 9 clinical cases of traumatic orbital compression are presented, each characterized by distinct etiologies. The study delves into traumatic orbital compressive syndromes, underscoring the critical imperative of early recognition and treatment to prevent vision loss. Orbital compression, whether from edema, hematoma, or emphysema, collectively culminates in elevated intraorbital pressure and the potential for optic nerve ischemia. Through the presentation of these 9 clinical cases, the article emphasizes the pressing need for timely intervention in addressing orbital compressive syndromes to avert vision loss. Various surgical techniques are elucidated, highlighting the pivotal role of expeditious medical intervention. This article offers invaluable insights into the diagnosis, management, and outcomes of traumatic orbital compressive syndromes.
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Affiliation(s)
- José Cleveilton Dos Santos
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara
| | | | - Roberto Moreno
- Private Clinic Departament, Oral and Maxillofacial Surgeon, São Paulo, Brazil
| | - Marcelo Silva Monnazzi
- Department of Diagnostic and Surgery, School of Dentistry, São Paulo State University (Unesp), Araraquara
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I P, V P, S-E S, P S, M B, L G, A T. Acute orbital compartment syndrome due to traumatic hemorrhage: 4-year case series and relevant literature review with emphasis on its management. Oral Maxillofac Surg 2023; 27:101-116. [PMID: 35083570 DOI: 10.1007/s10006-021-01036-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 12/28/2021] [Indexed: 11/26/2022]
Abstract
PURPOSE Blindness in craniomaxillofacial (CMF) injuries may occur due to acute orbital compartment syndrome (AOCS). Primarily, this article aimed to retrospectively review our 4-year experience in the management of patients diagnosed with AOCS secondary to an orbital hematoma (OH). Furthermore, this paper included up-to-date information regarding the prevalence, diagnosis, management, and prognosis of AOCS. MATERIALS AND METHODS We retrospectively screened the medical records of patients who visited our hospital's emergency department (ED) and were examined by an oromaxillofacial surgeon for CMF injuries, between September 1, 2013, and September 31, 2017. The electronic hospital's database was searched to retrieve all cases of CMF trauma admitted or referred to our clinic during this period. RESULTS Over a 49-month period, 3,514 patients were managed for CMF injuries in ED; 9 cases (0.26%) were attributed to OCS caused by an OH. This group comprised 5 males and 4 females aged between 32 and 91 years old (mean 65.7, median 70). Seven out of 9 patients were subjected to lateral canthotomy and inferior cantholysis (LCIC), whereas septolysis was applied in 6 of them. Sight was preserved in 3 out of 8 patients (37.5%), since a patient died from a serious intracranial injury. Seven out of 9 patients (77.7%) of the OCS group had a history of hypocoagulable state. CONCLUSIONS LCIC, septolysis, and careful dissection within inferotemporal orbital quadrant constitute a reliable approach for emergent orbital decompression. CT scan offers differential diagnosis of acute traumatic proptosis, but it should preferably follow LCIC. In case of OHs without pupillary abnormalities and/or impairment of visual acuity, close monitoring allowing for timely interventions is highly recommended to patients with a history of hypocoagulative status, (uncontrolled or severe) hypertension, head trauma, and decreased level of consciousness or in elderly patients suffering from dementia or without rapid access to follow-up medical care. Clinicians dealing with ED services must maintain high skills in AOCS diagnosis and in LCIC execution.
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Affiliation(s)
- Papadiochos I
- Attikon" University General Hospital, Chaidari, Medical School of Athens, Athens, Greece.
| | - Petsinis V
- School of Dentistry, Athens, Greece
- OMFS Clinic of "Evaggelismos" Gereral Hospital, Athens, Greece
| | - Sarivalasis S-E
- Department of Plastic Surgery, Hygeia Hospital, Athens, Greece
| | - Strantzias P
- OMFS Clinic of "Panagiotis and Aglaia Kyriakou" Children's Hospital of Athens, Athens, Greece
| | - Bourazani M
- OMFS Clinic of "Evaggelismos" Gereral Hospital, Athens, Greece
| | - Goutzanis L
- School of Dentistry, Athens, Greece
- OMFS Clinic of "Panagiotis and Aglaia Kyriakou" Children's Hospital of Athens, Athens, Greece
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[Optic nerve decompression-state of the art]. HNO 2022; 70:736-742. [PMID: 35980401 DOI: 10.1007/s00106-022-01209-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/22/2022] [Indexed: 11/04/2022]
Abstract
Rarely, but often with serious consequences for the patient, the optic nerve is affected during the course of head injuries. Traumatic optic nerve compression is always an emergency situation, which is why time is of the essence for both diagnosis and treatment. Precise knowledge of this accident sequelae but also of the resulting conditions, especially in terms of traumatic optic neuropathy, is indispensable for adequate patient care. The aim of this paper is to provide an overview of this clinical picture, particularly with regard to etiology, diagnosis, and treatment options, and to discuss this in the context of the current literature.
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Gellrich NC, Rahlf B, Jehn P, Spalthoff S, Korn P. Outcome and Quality of Life after Individual Computer-AssistedReconstruction of the Midface. Laryngorhinootologie 2022; 101:S90-S102. [PMID: 35605614 DOI: 10.1055/a-1669-6154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Often, midfacial defects are not only relevant regarding functional aspects but also esthetics of such congenital or acquired deformities impair significantly the patients' quality of life. Reconstructions of the midface do not only include replacing lost or non-developed tissue but moreover to achieve predictable results with regard to esthetics as well as function for the individual patient. Digital planning modalities including different surface and volume data in combination with modern additive manufacturing techniques for biomodel and implant production and intraoperative support by using real and virtual 3D volume data for navigation and intraoperative imaging, but also securing the outcome based on postoperative analysis have been implemented in modern midface reconstruction and represent new standards for medical care. The objective of this paper is to describe modern options of patient-specific midfacial reconstruction with integration of computer-assisted planning and production techniques.
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Affiliation(s)
- Nils-Claudius Gellrich
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Björn Rahlf
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Philipp Jehn
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Simon Spalthoff
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
| | - Philippe Korn
- Klinik und Poliklinik für Mund-, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Hannover, Deutschland
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Gellrich NC, Eckstein FM, Lentge F, Zeller AN, Korn P. [Complex reconstructions in the facial and cranial regions]. Unfallchirurg 2021; 124:807-816. [PMID: 34499183 DOI: 10.1007/s00113-021-01076-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2021] [Indexed: 10/20/2022]
Abstract
Posttraumatic reconstruction of the neurocranium and viscerocranium is an essential part of modern oral and maxillofacial surgery, in addition to oncological surgery, surgery of congenital craniofacial deformities and dental surgery. Due to the complex anatomy of the facial skull and significant esthetic and functional demands on its reconstruction, reconstructive trauma surgery in this area places the highest demands on the surgeon. This is all the more true if definitive craniomaxillofacial surgical treatment can sometimes only be performed with considerable delays for the benefit of other life-threatening injuries. In order to take these prerequisites into account, achievements of modern biomedical technology, such as intraoperative real-time navigation, computer-assisted planning and computer-assisted manufacturing (CAD/CAM) of patient-specific biomodels and implants, came up early for use in oral and maxillofacial surgery. In combination with intraoperative three-dimensional imaging, these methods result in a treatment pathway tailored to the individual patient, which is directly checked for quality at every step and thus ensures the best possible result for the patient. The use of these technologies extends far beyond the original indications in the area of orbital reconstruction and restoration of bony defects with simple geometry, such as skull defects. Nowadays, even the most complex pan-facial fractures can be restored esthetically and functionally by means of digitalized preliminary planning and individualized skull, orbital and zygomatic implants as well as total temporomandibular joint prostheses.
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Affiliation(s)
- Nils-Claudius Gellrich
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland.
| | - Fabian Matthias Eckstein
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Fritjof Lentge
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Alexander-Nicolai Zeller
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
| | - Philippe Korn
- Klinik und Poliklinik für Mund‑, Kiefer- und Gesichtschirurgie, Medizinische Hochschule Hannover, Carl-Neuberg-Str. 1, 30625, Hannover, Deutschland
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Riekert M, Schick VC, Schumacher L, Zöller JE, Kreppel M, Schick T. Volumetric Analysis and Clinical Outcome in 54 Patients with Retrobulbar Hematoma. J Oral Maxillofac Surg 2021; 79:1914-1920. [PMID: 34153252 DOI: 10.1016/j.joms.2021.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Accepted: 05/04/2021] [Indexed: 11/16/2022]
Abstract
PURPOSE Retrobulbar hematoma (RBH) is a rare but serious vision threatening emergency. We analyze the relationship between hematoma volume, visual impairment and outcome. METHODS Fifty-four patients with RBH receiving orbital decompression were retrospectively included. Volumetric analysis of RBH was performed by semi-automatic segmentation based on preoperative CT scans using ITK-SNAP software. Best corrected visual acuity (BCVA) measurements were obtained and correlated in 2 groups (no light perception (NLP), severe visual impairment) with the hematoma volume. RESULTS NLP was documented preoperatively in 5/28 and postoperatively in 9/43 patients. Preoperative NLP was significantly associated with a larger hematoma volume (P = .03) and higher hematoma/orbital volume ratio (P = .03). Postoperative severe visual impairment showed significant associations with a larger hematoma volume (P = .02) as well as higher hematoma/orbital volume ratio (P = .02). CONCLUSION Eyes with severe visual impairment and large hematoma volumes preoperatively are at high risk of permanent vision loss. Hematoma volume calculation might represent an additional prognostic parameter for visual outcome after RBH.
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Affiliation(s)
- Maximilian Riekert
- Department of Oral and Craniomaxillofacial and Plastic Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.
| | - Volker C Schick
- Department of Anaesthesiology and Intensive Care Medicine, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Laura Schumacher
- Department of Oral and Craniomaxillofacial and Plastic Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Joachim E Zöller
- Department of Oral and Craniomaxillofacial and Plastic Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Matthias Kreppel
- Department of Oral and Craniomaxillofacial and Plastic Surgery, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Tina Schick
- Department of Ophthalmology, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; MVZ Augenärztliches Diagnostik- und Therapiecentrum Siegburg GmbH, Siegburg, Germany
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Postoperative severe visual impairment: surgical outcome of 165 patients with orbital tumours in the muscle cone. Eye (Lond) 2020; 35:2535-2542. [PMID: 33184490 DOI: 10.1038/s41433-020-01270-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Revised: 10/24/2020] [Accepted: 10/28/2020] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the risk factors of postoperative severe vision impairment (PSVI) for a primary orbital tumour in the muscle cone. METHODS A retrospective analysis of the patients who underwent orbitotomy for primary intraconal tumours at the Tianjin Medical University Eye Hospital from January 2010 to December 2015. RESULTS A total of 165 cases of orbitotomy for primary orbital tumours in the muscle cone were included in the study. Postoperatively, 12 cases with vision acuity ≤20/400 or ≥4 rows of vision decline and without any corrected effect were analysed as PSVI, including no light perception (NLP) for 3 cases. The multivariate logistic regression indicated that the tumour in orbital apex (P = 0.048, OR = 4.912, 95% CI: 1.011-23.866), severe optic nerve displacement (P = 0.030, OR = 6.007, 95% CI: 1.184-30.473) and intraoperative tight adhesion (P = 0.003, OR = 12.031, 95% CI: 2.282-63.441) were the independent risk factors for PSVI. CONCLUSIONS The incidence of PSVI for the intraconal tumour was 7.3%, and the incidence of NLP was 1.8%. The tumour in orbital apex, severe optic nerve displacement and intraoperative tight adhesion were independent risk factors for PSVI.
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Berg BI, Flury E, Thieringer FM, Augello M, Savic M, Schötzau A, Kunz C, Goldblum D. Retrobulbar haematoma in the era of anticoagulants. Injury 2019; 50:1641-1648. [PMID: 31519435 DOI: 10.1016/j.injury.2019.08.035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 08/12/2019] [Accepted: 08/19/2019] [Indexed: 02/02/2023]
Abstract
AIM The present retrospective study aimed to evaluate the frequency and distribution of retrobulbar haematoma (RBH) among 26 patients (12 male/14 female) who had suffered maxillofacial trauma/surgery, with special focus on anticoagulants, causes of accidents, treatment, and outcome. METHODS Patient ages ranged from 8 to 94 years, with a mean of 65 years. Among all patients, 43% had received anticoagulant therapy at admission; 92.3% had a previous history of maxillofacial trauma. RESULTS The most frequent cause of RBH were falls (65.4%), and three patients experienced RBH postoperatively after treatment using polydioxanone foil. Postoperatively (after RBH relief), 33.3% of the patients reported persistent complete visual loss; of these patients, 29% had received anticoagulation therapy, and the oral anticoagulant intake was not documented in further 29% of the patients. CONCLUSION Awareness of this pathologic process is crucial for preventing permanent loss of vision via early diagnosis and adequate therapy. With increasing age, patients are more likely to receive an anticoagulant, which leads to a higher risk of RBH. Because falling was the most frequent cause of RBH in our patient population and increases in frequency with increasing age, fall prevention is crucial.
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Affiliation(s)
- Britt-Isabelle Berg
- University Hospital Basel, Department of Oral and Cranio-Maxillofacial Surgery, Basel, Switzerland
| | - Emanuel Flury
- University Hospital Basel, Department of Oral and Cranio-Maxillofacial Surgery, Basel, Switzerland
| | - Florian M Thieringer
- University Hospital Basel, Department of Oral and Cranio-Maxillofacial Surgery, Basel, Switzerland; Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Basel, Switzerland.
| | - Marcello Augello
- Department of Cranio-Maxillofacial Surgery, Kantonsspital Aarau, Aarau, Switzerland
| | - Miodrag Savic
- University Hospital Basel, Department of Oral and Cranio-Maxillofacial Surgery, Basel, Switzerland; Medical Additive Manufacturing Research Group, Department of Biomedical Engineering, University of Basel, Basel, Switzerland
| | - Andreas Schötzau
- Department of Ophthalmology, University Hospital of Basel and University of Basel, Basel, Switzerland
| | - Christoph Kunz
- University Hospital Basel, Department of Oral and Cranio-Maxillofacial Surgery, Basel, Switzerland
| | - David Goldblum
- Department of Ophthalmology, University Hospital of Basel and University of Basel, Basel, Switzerland
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Bony Orbital Decompression Following Lateral Canthotomy and Cantholysis for Traumatic Orbital Compartment Syndrome. J Craniofac Surg 2019; 30:231-234. [DOI: 10.1097/scs.0000000000004902] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Acute Monocular Blindness Due to Orbital Compartment Syndrome Following Pterional Craniotomy. World Neurosurg 2018; 114:72-75. [PMID: 29545222 DOI: 10.1016/j.wneu.2018.03.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2018] [Revised: 02/28/2018] [Accepted: 03/02/2018] [Indexed: 11/21/2022]
Abstract
BACKGROUND We present a case of orbital compartment syndrome (OCS) leading to monocular irreversible blindness following a pterional craniotomy for clipping of an anterior communicating artery aneurysm. OCS is an uncommon but vision-threatening entity requiring urgent decompression to reduce the risk of permanent visual loss. Iatrogenic orbital roof defects are a common finding following pterional craniotomies. However, complications related to these defects are rarely reported. CASE DESCRIPTION A 65-year-old female who underwent an anterior communicating artery clipping via a pterional approach 4 days before developed proptosis, ocular movement paresis, and irreversible visual impairment following an orthopedic surgery. Computed tomography images revealed an intraorbital cerebrospinal fluid (CSF) collection, which was evacuated via an acute recraniotomy. The next day, proptosis and intraorbital CSF collection on computed tomography images reoccurred and an oral and maxillofacial surgeon evacuated the collection via a blepharoplasty incision and blunt dissection. In addition, the patient was treated with acetazolamide and an external lumbar CSF drainage during 12 days. Hereafter, the CSF collection did not reoccur. Unfortunately, monocular blindness was persistent. We hypothesize the CSF collection occurred due to the combination of a postoperative orbital roof defect and a temporarily increased intracranial pressure during the orthopedic surgery. CONCLUSION We plead for more awareness of this severe complication after pterional surgeries and emphasize the importance of 1) strict ophthalmologic examination after pterional craniotomies in case of intracranial pressure increasing events, 2) immediate consultation of an oral and maxillofacial surgeon, and 3) consideration of CSF-draining interventions since symptoms are severely invalidating and irreversible within a couple of hours.
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Christie B, Block L, Ma Y, Wick A, Afifi A. Retrobulbar hematoma: A systematic review of factors related to outcomes. J Plast Reconstr Aesthet Surg 2017; 71:155-161. [PMID: 29239798 DOI: 10.1016/j.bjps.2017.10.025] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2017] [Revised: 10/06/2017] [Accepted: 10/13/2017] [Indexed: 11/19/2022]
Abstract
INTRODUCTION Retrobulbar hematoma (RBH), a rare but serious condition, can result in permanent vision loss. Although it is a known complication following trauma or facial fracture reduction, sinus surgery, or blepharoplasty, factors related to patient outcomes are not well-defined. A systematic review was performed to determine the relation of patient/treatment factors to outcomes. METHODS Articles retrieved from a PubMed search (1989-2017) were reviewed. Demographic information, etiology, symptoms, and final vision outcomes were analyzed using Fisher's exact tests, single and multiple predictor logistic regression. RESULTS Of 429 articles identified, 16 were included in the study. 93 cases of retrobulbar hematoma were included. 74% occurred after trauma, while 26% occurred postoperatively. Onset of symptoms occurred after approximately 24 hours. 28% received treatment within 1 hour, 54% within 1-24 hours, and 18% after 24 hours. 51% had complete visual recovery, while 27% had partial recovery, and 22% developed blindness. Older patients and patients who sustained trauma were less likely to have a full recovery (p = 0.029, p = 0.023). Increasing number of symptoms trended towards a prediction of blindness (p = 0.092). Surgical decompression and shorter time to treatment were each highly predictive of full recovery (p = 0.024, p = 0.003) and decreased likelihood of blindness (p = 0.037, p = 0.045); use of steroids was not found to be significant. DISCUSSION Retrobulbar hematoma is a diagnostic and therapeutic emergency. Factors associated with improved outcomes include younger age, decreased number of total symptoms, surgical decompression, and shorter time to treatment. If recognized and treated early with surgical decompression, recovery of vision is possible.
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Affiliation(s)
- Brian Christie
- Division of Plastic Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792
| | - Lisa Block
- Division of Plastic Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792
| | - Yue Ma
- Division of Plastic Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792
| | - Alexandra Wick
- Division of Plastic Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792
| | - Ahmed Afifi
- Division of Plastic Surgery, University of Wisconsin-Madison, 600 Highland Avenue, Madison, WI 53792; Department of Plastic Surgery, Cairo University, Cairo, Egypt.
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Politis C, Kluyskens A, Dormaar T. Association of Midfacial Fractures with Ophthalmic Injury. Craniomaxillofac Trauma Reconstr 2017; 10:99-105. [PMID: 28523083 DOI: 10.1055/s-0037-1599228] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2016] [Accepted: 09/28/2016] [Indexed: 10/20/2022] Open
Abstract
The aim of this study is to evaluate the incidence of ophthalmic complications following midfacial fractures and investigate its relation to surgical or nonsurgical treatment. This article is a retrospective study, describing the spectrum and incidence of ophthalmic injury in 106 patients presenting with midfacial fractures at the Department of Oral and Maxillofacial Surgery of the University Hospitals Leuven over a period of 16 months (January 2013 to April 2014). The mean age of the patients was 45.6 years with a gender distribution of 68 men and 38 women. The main cause of trauma was road traffic accidents. Forty-one patients suffered an ophthalmic injury following the fracture. Twelve of them had a persistent ophthalmic problem. Ophthalmic examination is necessary during the initial management. The time window for preservation of sight is small and treatment should be started immediately. Development of an emergency trauma scale that includes fractures, symptoms of visual impairment, and patient history is recommended and should stimulate a multidisciplinary approach of complex cases.
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Affiliation(s)
- Constantinus Politis
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium
| | - Alexandra Kluyskens
- Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium
| | - Titiaan Dormaar
- OMFS IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven and Oral and Maxillofacial Surgery, University Hospitals Leuven, Leuven, Belgium.,Department of Oral and Maxillofacial Surgery, Leuven University Hospitals, Leuven, Belgium
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Zimmerer RM, Ellis E, Aniceto GS, Schramm A, Wagner ME, Grant MP, Cornelius CP, Strong EB, Rana M, Chye LT, Calle AR, Wilde F, Perez D, Tavassol F, Bittermann G, Mahoney NR, Alamillos MR, Bašić J, Dittmann J, Rasse M, Gellrich NC. A prospective multicenter study to compare the precision of posttraumatic internal orbital reconstruction with standard preformed and individualized orbital implants. J Craniomaxillofac Surg 2016; 44:1485-97. [DOI: 10.1016/j.jcms.2016.07.014] [Citation(s) in RCA: 99] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2016] [Revised: 06/07/2016] [Accepted: 07/13/2016] [Indexed: 11/25/2022] Open
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Soare S, Foletti JM, Gallucci A, Collet C, Guyot L, Chossegros C. Update on orbital decompression as emergency treatment of traumatic blindness. J Craniomaxillofac Surg 2015; 43:1000-3. [DOI: 10.1016/j.jcms.2015.05.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2015] [Revised: 04/10/2015] [Accepted: 05/19/2015] [Indexed: 10/23/2022] Open
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