Blow-In Fractures of the Orbit

Antonyshyn, Oleh; Gruss, Joseph S.; Kassel, Edward E.

doi:10.1097/00006534-198907000-00002

Cited by 96 publications

(64 citation statements)

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“…A proposed rare cause of O R F, reported in adults [22][23][24], is sudden increase in intracranial pressure within the anterior fossa sufficient to cause the orbital roof to give way, allowing extrusion of brain into the orbit [4].…”

Section: Discussionmentioning

confidence: 99%

Intracranial Neurological Injuries Associated with Orbital Fracture

et al. 1997

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We attempted to define the central nervous system (CNS) concomitants of various types of orbital fractures in children by reviewing the records of 95 inpatients with admission diagnoses including orbital fracture who presented to the Children’s National Medical Center from 1987 through 1994. Patients were divided into three age groups: group I: 0–5 years; group II: 6–12 years; group III: older than 12 years. Orbital fractures were classified by location: roof alone (A); orbital roof plus another orbital wall (B), and orbital fractures sparing the roof (C). Mechanisms of injury included falls (F), motor vehicle accidents (M), and blunt injuries (S). Admission Glasgow Coma Scale (GCS), neurosurgical intervention, nature of associated intracranial injury, and presence of residual neurologic deficit were recorded. Group I included 38 patients, while groups II and III included 28 and 29, respectively. There were 61 boys and 34 girls. Most fractures confined to the roof occurred in group I patients (12 of 16 fractures; 75%). Twenty-four of the 38 group I patients (63%) sustained orbital fractures involving the roof compared to 12 (43%) and 6 (21%) in groups II and III, respectively. Children with orbital fractures involving the roof and another orbital wall, regardless of age, had lower admission GCS. Over half of type B fracture patients (19/26) were involved in motor vehicle accidents. Intracranial injuries were identified in 26 of the 73 patients (36%) whose CT included the brain. Fifteen of 26 patients (58%) with intracranial injuries sustained fractures involving the orbital roof, but only 3 of these had a type A fracture. Seven of the patients with intracranial injury required emergent neurosurgical procedures. Younger children with maxillofacial injury sparing the orbital roof appear more likely to have coexisting intracranial injury, as reflected by CT findings and GCS on admission, than their older cohorts with similar injuries. Fracture of more than one orbital wall greatly increases risk of concurrent intracranial injury in all age groups.

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Section: Discussionmentioning

confidence: 99%

Intracranial Neurological Injuries Associated with Orbital Fracture

et al. 1997

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“…2 Although it is generally agreed that some fractures of the orbit benefit from reduction of the rim and decompression exploration of the fissure, linear fractures that are not displaced are less likely to benefit and the surgical intervention itself may cause iatrogenic damage to the optic nerve. 15,16 In our case, the treatment for a third nerve injury of this type is made difficult by the location of the bone fragment and the likelihood of aberrant third nerve regeneration with or without treatment. In review of the literature and because of the scarcity of cases of traumatic SOFS, there is little available on the surgical approach for decompression of isolated traumatic SOFS resulting from a bony fragment.…”

Section: Discussionmentioning

confidence: 87%

Neuronavigation-Guided Endoscopic Decompression of Superior Orbital Fissure Fracture: Case Report and Literature Review

Gasco¹,

Hooten²,

Ridley³

et al. 2009

Skull Base

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Objective: We present a rare case of an isolated superior orbital fissure fracture resulting from blunt injury to the face and presenting with selective cranial nerve deficits surgically treated with a neuroendoscopic approach. The anatomy of the superior orbital fissure is detailed, and the peculiarities of the surgical approach described. Method: A review of the existing literature reveals this is the first reported case of a neuronavigation-assisted endoscopic approach used in the extraction of a superior orbital fracture fragment with good outcome. Current guidelines for an endoscopic approach in orbital trauma are reviewed, and pertinent literature is discussed. Conclusion: Neuronavigation-assisted decompression should be considered as an effective means of removing superior orbital fissure fractures.

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“…The lateral orbital wall about 30 mm from the orbital rim is very thick [14]. With blow-in fractures of the lateral orbital wall, skull fractures, eyeball ruptures and optic nerve injuries might occur [15,16,17]. However, there are no reports of abducent nerve palsy in these states [15,16,17].…”

Section: Discussionmentioning

confidence: 99%

“…With blow-in fractures of the lateral orbital wall, skull fractures, eyeball ruptures and optic nerve injuries might occur [15,16,17]. However, there are no reports of abducent nerve palsy in these states [15,16,17]. When an external force acts on the lateral wall in a blow-in fracture, the MNJ of the LR moves inside due to loosening of nerve tension, such that the LR might prevent palsy.…”

Section: Discussionmentioning

confidence: 99%

Myoneural Junctions of Extraocular Muscles: Distances from the Orbital Rim and Widths

Kakizaki¹,

Zako²,

Nakano³

et al. 2006

Ophthalmologica

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Purpose: To examine both the distances from the orbital rim to the myoneural junctions (MNJs) and the widths of the MNJs of all extraocular muscles. Methods: Six orbits of 3 post-mortem cadavers were used. The cadavers (1 female and 2 males) were all Japanese with an average age of 76.3 years. The MNJs of the extraocular muscles and their motor nerves were exposed, and then the distance from the orbital rim to each MNJ and the width of each MNJ were examined. Results: The distance from the orbital rim to each MNJ in the 6 extraocular muscles ranged from 24.4 to 33.6 mm and the width of each MNJ ranged from 5.0 to 8.5 mm. Conclusions: It is essential for orbital surgeons to understand both the distance from the orbital rim to MNJs and the widths of MNJs. This information not only aids the understanding of MNJ damage, but also prevents iatrogenic nerve impairment during orbital surgery.

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Blow-In Fractures of the Orbit

Cited by 96 publications

References 0 publications

Intracranial Neurological Injuries Associated with Orbital Fracture

Intracranial Neurological Injuries Associated with Orbital Fracture

Neuronavigation-Guided Endoscopic Decompression of Superior Orbital Fissure Fracture: Case Report and Literature Review

Myoneural Junctions of Extraocular Muscles: Distances from the Orbital Rim and Widths

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