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kIm H, Kim KH, Koh IC, Lee GH, Lim SY. Delayed treatment of traumatic eyeball dislocation into the maxillary sinus and treatment algorithm: a case report and literature review. Arch Craniofac Surg 2024; 25:31-37. [PMID: 38461826 PMCID: PMC10924793 DOI: 10.7181/acfs.2023.00535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 11/03/2023] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
Orbital floor fractures are commonly encountered, but the dislocation of the eyeball into the maxillary sinus is relatively rare. When it does occur, globe dislocation can have serious consequences, including vision loss, enucleation, and orbito-ocular deformity. Immediate surgical intervention is typically attempted when possible. However, severe comorbidities and poor general health can delay necessary surgery. In this report, we present the surgical outcomes of a 70-year-old woman who received delayed treatment for traumatic eyeball dislocation into the maxillary sinus due to a subarachnoid hemorrhage and hemopneumothorax. Additionally, we propose a treatment algorithm based on our clinical experience and a review of the literature.
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Affiliation(s)
- Hoon kIm
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, Konyang University of College of Medicine, Daejeon, Korea
| | - Keun Hyung Kim
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, Konyang University of College of Medicine, Daejeon, Korea
| | - In Chang Koh
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, Konyang University of College of Medicine, Daejeon, Korea
| | - Ga Hyun Lee
- Department of Ophthalmology, Konyang University Hospital, Konyang University of College of Medicine, Daejeon, Korea
| | - Soo Yeon Lim
- Department of Plastic and Reconstructive Surgery, Konyang University Hospital, Konyang University of College of Medicine, Daejeon, Korea
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Vránová K, Chytilová K, Dobiáš M, Tvrdý P, Handlos P. Traumatic dislocation of the eye into the maxillary sinus: Case report and literature review. J Forensic Sci 2021; 66:2002-2005. [PMID: 33895989 DOI: 10.1111/1556-4029.14742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 04/01/2021] [Accepted: 04/08/2021] [Indexed: 11/27/2022]
Abstract
Traumatic dislocation of the eye is usually encountered in high-energy injuries. These include traffic accidents, accidents at work, sporting accidents, falling from a height, impact of the hooves or horns of animals, gunshot injuries, and physical assault. Such incidents are accompanied by facial soft tissue damage and injuries to the facial skeleton, especially the orbit, and can be associated with varying degrees of dislocation of the eye. We describe a rare case of non-fatal traumatic eye dislocation into the maxillary sinus, coupled with an orbital fracture resulting from a physical assault on a 63-year-old woman. The cause of death was asphyxiation due to manual strangulation and mechanical asphyxia. Even though dislocations of the eye are relatively rare, forensic pathologists should be aware of such injuries to correct assessment of injury mechanism. The available literature regarding eye dislocation is summarized, and the forensic issues applicable to the assessment of such cases are reviewed.
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Affiliation(s)
- Kateřina Vránová
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Olomouc, Czech Republic
| | - Karin Chytilová
- Department of Oral and Maxillofacial Surgery, Faculty Hospital in Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Martin Dobiáš
- Department of Forensic Medicine and Medical Law, University Hospital Olomouc, Olomouc, Czech Republic
| | - Peter Tvrdý
- Department of Oral and Maxillofacial Surgery, Faculty Hospital in Olomouc and Faculty of Medicine and Dentistry, Palacký University Olomouc, Olomouc, Czech Republic
| | - Petr Handlos
- Institute of Forensic Medicine, University Hospital Ostrava, Ostrava, Czech Republic
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Bastos RM, Taparello C, Tres R, Sawazaki R. Orbital Blowout Fracture With Globe Displacement Into the Maxillary Sinus: A Case Report and Literature Review. J Oral Maxillofac Surg 2021; 79:204.e1-204.e12. [PMID: 33080207 DOI: 10.1016/j.joms.2020.09.034] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 09/19/2020] [Accepted: 09/21/2020] [Indexed: 11/23/2022]
Abstract
Blunt trauma in the orbital region often results in fracture of 1 or more bone walls resulting in alteration of the orbital volume with the potential for visual sequelae. This study reports a rare case of displacement of the eyeball into the maxillary sinus after blunt trauma as well as its initial management, treatment, and clinical follow-up. Victims of eyeball displacement have a poor visual prognosis. Even if the patient has already been diagnosed with amaurosis on arrival to the hospital, all measures for rapid eye repositioning and reconstruction of the orbital cavity must be instituted, as well as appropriate clinical and pharmacologic management to avoid further complications.
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Abstract
Background Orbital fracture associated with traumatic intracranial prolapse of the eyeball is rare. In all previously reported cases, vision was severely impaired with no light perception. Herein, we report a case of traumatic prolapse of the globe into the anterior cranial fossa, in which the patient’s vision was preserved by early repositioning. Case presentation The present case report focused on a man hit by a steel pipe, leading to prolapse of the globe of the right eye into the anterior cranial fossa through fractures in the superior orbit roof, accompanied by cerebral contusion. The eyeball was immediately repositioned into the orbital cavity, along which the wound tract was debrided and the skull base was repaired. The patient underwent a follow-up period of 12 months, during which the visual acuity increased to 12/20 without any intracranial infections. However, the patient’s ptosis persisted and was associated with complete loss of supraduction. Conclusions In this case, early diagnosis and proper globe repositioning with reconstruction of the orbital roof could allow recovery of vision, as well as prevention of intracranial infection.
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Affiliation(s)
- Hui Liu
- Department of Ophthalmology, Chengdu Aier Eye Hospital, Chengdu, China.,Department of Ophthalmology, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Shengli Hu
- Department of Neurosurgery, Southwest Hospital, Third Military Medical University, Chongqing, China
| | - Wei Qin
- Department of Ophthalmology, Southwest Hospital, Third Military Medical University, Chongqing, China. .,Department of Ophthalmology, Chungking General Hospital, Chongqing, China.
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Abstract
Traumatic globe dislocation into the maxillary sinus is a rare event and usually associated with a poor visual outcome if not managed appropriately. We report a 45-year-old female patient who presented to the emergency after blunt injury to her face with a door. Initial evaluation revealed nil perception of light and an apparently anophthalmic socket. Neuroimaging revealed large floor and medial wall fracture with dislocation of the globe into the maxillary sinus. The patient underwent exploration with repositioning of the globe and fracture repair. She was also administered 1 g intravenous methylprednisolone along with tapering course of oral steroids for 3 days. Patient's final visual acuity at 18 months of follow-up improved to counting fingers at 1 m. A thorough review of the literature suggests immediate surgery might improve the final visual outcome in such cases.
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Affiliation(s)
- Md Shahid Alam
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Bipasha Mukherjee
- Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
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Noman SA, Shindy MI. Immediate Surgical Management of Traumatic Dislocation of the Eye Globe into the Maxillary Sinus: Report of a Rare Case and Literature Review. Craniomaxillofac Trauma Reconstr 2016; 10:151-158. [PMID: 28523089 DOI: 10.1055/s-0036-1584393] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2015] [Accepted: 02/28/2016] [Indexed: 01/16/2023] Open
Abstract
We report a case of complete dislocation of the globe into the maxillary sinus, with immediate repositioning of the globe. This report highlights the importance of early surgical repair of orbital fracture and globe repositioning to regain the maximum amount of ocular functions. A review of literature found 19 cases of globe dislocation into the maxillary sinus: One case was enucleated 2 months after misdiagnosis as traumatic enucleation, six cases were documented no vision or no light perception, three cases did not have reported vision (patients did not survive), and nine cases with postoperative vision. We recommend early surgical intervention to restore the cosmetic and visual function of the dislocated eye.
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Affiliation(s)
- Samer Abduljabar Noman
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Sana'a University, Sana'a, Yemen
| | - Mostafa Ibrahim Shindy
- Department of Oral and Maxillofacial Surgery, Faculty of Oral and Dental Medicine, Cairo University, Cairo, Egypt
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Haggerty CJ, Roman P. Repositioning of a traumatically displaced globe with maxillary antrostomy: review of the literature and treatment recommendations. J Oral Maxillofac Surg 2013; 71:1915-22. [PMID: 23993226 DOI: 10.1016/j.joms.2013.07.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2013] [Revised: 07/01/2013] [Accepted: 07/01/2013] [Indexed: 01/31/2023]
Abstract
Complete dislocation of the globe, inferiorly into the maxillary sinus, medially into the ethmoid sinus, or superiorly into the anterior cranial fossa, can occur with significant blunt facial trauma. The degree of injury to the globe, its adnexal structures, and the optic nerve is dependent on the extent of the dislocation. Complete traumatic subluxation of the globe into the maxillary sinus is associated with severe injury to the periocular structures and represents a challenging and unique reconstructive process rarely encountered in published studies. The present case report represents only the 15th reported case of complete orbital prolapse into the maxillary sinus. Controversy exists regarding the definitive treatment of traumatic globe dislocations, the risk of sympathetic ophthalmia (SO), the sequela of postenucleation socket syndrome, and prophylactic steroid treatment to decrease the incidence of SO and traumatic optic neuropathy.
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Affiliation(s)
- Christopher J Haggerty
- Private Practice, Lakewood Oral and Maxillofacial Surgery Specialists, Lees Summit, MO; Clinical Assistant Professor, Department of Oral and Maxillofacial Surgery, University of Missouri-Kansas City Medical Center, Kansas City, MO.
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Zhang-Nunes SX, Jarullazada I, Mancini R. Late central visual recovery after traumatic globe displacement into the maxillary sinus. Ophthalmic Plast Reconstr Surg 2012; 28:e17-9. [PMID: 21490518 DOI: 10.1097/IOP.0b013e318213f5fb] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Globe prolapse into the maxillary sinus after trauma is rare and usually portends a very poor visual prognosis. The authors present an unusual case of late restoration of central vision after such trauma. A 20-year-old man presented after motorcycle injury with a large right floor and medial orbital wall fracture with displacement of the globe into the maxillary sinus. The patient had no light perception on initial exam and was emergently taken to the operating room for globe exploration. No globe rupture was found, and the right orbital floor and medial wall fractures were repaired. Three days of intravenous methylprednisolone at 250 mg every 6 hours was administered postoperatively with no change in visual status, and the patient was discharged home on a rapid oral prednisone taper. At postoperative week 6, vision had returned to 20/20 OD centrally. Visual field testing revealed a central tunnel of vision. The patient's visual function continues to remain stable 2 years after the initial trauma.
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Abstract
CASE REPORT We report a case of traumatic dislocation of the globe into the maxillary sinus following a bull-riding incident. COMMENTS Traumatic dislocations of the eye into the sinuses are rare, and urgent management and surgical repair are indicated.
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Affiliation(s)
- Cory Ramstead
- Department of Ophthalmology, Royal Alexandra Hospital at the University of Alberta, 10240 Kingsway Avenue, Edmonton, Alberta, Canada.
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Lee KH, Ahn JH, Kyung SE, Chang MH. A Case of Dislocation of the Globe into the Maxillary Sinus after Orbital Wall Fracture. J Korean Ophthalmol Soc 2008. [DOI: 10.3341/jkos.2008.49.2.368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Kwan Hoon Lee
- Department of Ophthalmology, The Dankook University Medical College, Cheonan, Korea
| | - Jung Hyun Ahn
- Department of Ophthalmology, The Dankook University Medical College, Cheonan, Korea
| | - Seong Eun Kyung
- Department of Ophthalmology, The Dankook University Medical College, Cheonan, Korea
| | - Moo Hwan Chang
- Department of Ophthalmology, The Dankook University Medical College, Cheonan, Korea
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Kim S, Baek S. Traumatic dislocation of the globe into the maxillary sinus associated with extraocular muscle injury. Graefes Arch Clin Exp Ophthalmol 2005; 243:1280-3. [PMID: 15906074 DOI: 10.1007/s00417-004-1111-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2004] [Revised: 11/16/2004] [Accepted: 12/04/2004] [Indexed: 10/25/2022] Open
Abstract
BACKGROUND The mechanism of complete dislocation of an intact globe into the maxillary sinus after an extensive blowout fracture has not been clearly documented. METHODS A 68-year-old man sustained orbital wall fractures of the right orbit, resulting in dislocation of the globe into the maxillary sinus, associated with the transection of the medial and inferior rectus (MR and IR). We repaired the orbital wall fractures using Medpor barrier sheets, and repositioned the dislocated globe. And then, the distal section of the IR was sutured at its proximal end and the severed distal section of the MR was sutured at the fascial sheath and Tenon's capsule. RESULTS After repositioning, the eyeball was intact without signs of perforation, but the patient's visual acuity was impaired, exhibiting a loss of light perception, coupled with a noted pallor of the optic disc. The patient's eye movement was severely restricted, but supraduction and abduction proved possible. CONCLUSIONS This case demonstrates that the globe can be dislocated into the maxillary sinus following orbital wall fracture associated with extraocular muscle injury, and provides a clue into the mechanism underlying dislocation of the globe into the maxillary sinus.
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Affiliation(s)
- Seunghyun Kim
- Department of Ophthalmology, Korea University Ansan Hospital, Gyunggi-do, South Korea
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Abstract
Assessment of the orbit for orbital trauma is best achieved expeditiously with CT in the determination of extent of injury and the presence of foreign body. MR imaging has a limited role but is valuable in examining the optic nerve and globe for injury and has proven to be an adjunct modality in the assessment of orbital injury.
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Affiliation(s)
- John L Go
- Division of Neuroradiology, Department of Radiology, Keck School of Medicine, University of Southern California, 1200 North State Street, Room 3740F, Los Angeles, CA 90033, USA.
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Tung TC, Chen YR, Santamaria E, Chen CT, Lin CJ, Tsai TR. Dislocation of anatomic structures into the maxillary sinus after craniofacial trauma. Plast Reconstr Surg 1998; 101:1904-8. [PMID: 9623834 DOI: 10.1097/00006534-199806000-00019] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- T C Tung
- Division of Trauma and Emergency Surgery, Craniofacial Center, and Dental Department at Chang Gung Memorial Hospital, LinKou, Taiwan
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Rosbe KW, Meredith SD, Holmes DK. Complication of maxillary sinus Foley balloon placement for orbital floor support. Otolaryngol Head Neck Surg 1997; 117:S148-50. [PMID: 9419131 DOI: 10.1016/s0194-59989770085-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- K W Rosbe
- Department of Surgery, University of North Carolina School of Medicine, Chapel Hill 27599-7070, USA
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