Anomalous orbital structure mimicking fracture of orbital floor

Baldev, Vibha; Tibrewal, Shailja

doi:10.1016/j.jaapos.2020.01.016

Cited by 3 publications

(1 citation statement)

References 8 publications

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“…Although hypotropia, elevation limitation and tightness of the inferior rectus muscle in the forced duction test in our patient may suggest orbital floor fracture in the differential diagnosis, orbital floor fracture was ruled out because there was no history of trauma, the orbital rim was intact on palpation, there was no infraorbital numbness and enophthalmos, and no fracture was detected on imaging. Baldev et al 7 detected an orbital band similar to the one in our case arising from the orbit adjacent to the inferior rectus origin and attaching to the globe near the optic nerve on CT, in a patient presenting with hyperopia, enophthalmos, and elevation limitation in the OD that simulating orbital floor fracture with inferior rectus entrapment. Obeori et al 8 reported an orbital dermoid presenting as a case of MED with ptosis.…”

Section: Discussionsupporting

confidence: 71%

Orbital Fibrotic Band as Cause of Monocular Elevation Deficiency

Atilla,

Çaliş Karanfil,

Bingöl Kiziltunç

2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Monocular elevation deficiency is a congenital, unilateral inability of elevation. It is classified as innervational, restrictive, or combine types. Here, we report a rare case of monocular elevation deficiency who had 60 PD left hypotropia and left ptosis with limited elevation (−5) both on abduction and adduction. Orbital MRI revealed a hypointense fibrotic band between the superior oblique and superior rectus muscles extending obliquely in the superonasal direction between the sclera and orbital roof. She was successfully treated after severing the fibrotic band between the sclera and bony orbit.

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Section: Discussionsupporting

confidence: 71%

Orbital Fibrotic Band as Cause of Monocular Elevation Deficiency

Atilla,

Çaliş Karanfil,

Bingöl Kiziltunç

2023

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Challenges in management of congenital enophthalmos due to anomalous accessory orbital extraocular muscle bands

Goyal,

Tibrewal,

Lefebvre

et al. 2024

Strabismus

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Numerical Aberrations of the Extraocular Muscles and the Levator Palpebrae Superioris: An Anatomical and Clinical Insight

Tawfik,

El Houssieny,

Dutton

2024

Ophthalmic Plastic &Amp; Reconstructive Surgery

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Purpose: To comprehensively review the literature about numerical aberrations of the orbital muscles of ocular motility (here referred to as extraocular muscles [EOMs]) and the levator palpebrae superioris (LPS). Methods: The authors summarize the embryologic bases and the possible etiopathogenetic causes of numerical aberrations of the EOMs and the LPS and organize these lesions into several broad categories. The clinical and radiologic diagnostic challenges are discussed. Results: Numerical aberrations of the EOMs include: 1) the complete absence of EOMs, 2) duplication of an entire EOM, 3) the presence of muscle bands that connect 2 EOMs, and 4) minor morphological variations such as bifid muscles (partial splitting of the muscle). Some cases may defy categorization into any of the above or may resemble atavistic remnants of the retractor bulbi muscle. Broadly speaking, numerical aberrations of the LPS generally fall into the same categories although the LPS has several peculiar numerical anomalies of its own. Conclusions: Although numerical EOM and LPS variations are relatively rare and of little clinical significance, raising awareness about their presence is a fundamental clinical keystone not just for the strabismus surgeon but for the orbital surgeon as well. During orbital surgery, this may spare the surgeon from pursuing an orbital witch hunt for these benign innocuous accessory orbital structures that were accidentally discovered by the radiologist and misinterpreted as sinister etiologies. For the strabismus surgeon, the failure to identify them may result in an unfavorable surgical outcome if these structures are missed because of a lack of awareness despite being responsible for generating complex strabismus patterns or having a restrictive potential of their own.

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Anomalous orbital structure mimicking fracture of orbital floor

Cited by 3 publications

References 8 publications

Orbital Fibrotic Band as Cause of Monocular Elevation Deficiency

Orbital Fibrotic Band as Cause of Monocular Elevation Deficiency

Challenges in management of congenital enophthalmos due to anomalous accessory orbital extraocular muscle bands

Numerical Aberrations of the Extraocular Muscles and the Levator Palpebrae Superioris: An Anatomical and Clinical Insight

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