Incidence and Risk Factors of Inferior Rectus Muscle Palsy in Pediatric Orbital Blowout Fractures

Koh, Yan Tong; Chan, Errol W.; Amrith, Shantha

doi:10.1055/s-0037-1601884

Cited by 4 publications

(3 citation statements)

References 23 publications

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“…A second surgery will probably not improve this healing process. 10,11 In this material, it is clear that the time from trauma to surgery at our institution has become considerably shorter over the years (Supplemental Digital Content, Fig. 1, http://links.lww.com/SCS/ E721).…”

Section: Discussionmentioning

confidence: 99%

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Pediatric Orbital Fractures: Outcomes in Relation to Time of Surgery

Gudnadottir

Hammarfjord

Johansson

et al. 2023

Journal of Craniofacial Surgery

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Introduction: Orbital trapdoor fractures in children and adolescents can cause persistent problems with vision and appearance. Early surgery is recommended, although, because of the rarity of these fractures, there is a lack of evidence regarding the optimal timing of surgery.The objective of this study was to examine the effect of the time from trauma to surgery on the recovery time and severity of diplopia in children and adolescents with orbital trapdoor fractures. Materials and Methods: A retrospective cohort study was performed of all orbital fractures in children and adolescents aged 0 to 20 years, treated at a tertiary referral center in 2005-2017. Data relating to demographics, cause of injury, surgery, time of follow-up, and final outcomes were extracted. The cases of trapdoor fracture were specifically examined with regard to the time from trauma to surgery and diplopia at last follow-up, which was the primary outcome. Results: One hundred thirty-five patients, aged 2.4 to 20 years (mean 17.0), were treated for orbital fractures during the period; 37 (27%) had an isolated orbital floor fracture and 12 (9%) had a trapdoor fracture. All patients with trapdoor fractures underwent surgery; the mean time to surgery was 11.9 days in 2007-2011 and 1.1 days in 2012-2017. Although statistical significance cannot be proven in this small and retrospective study, a shorter time from trauma to surgery seems to lead to fewer problems with diplopia and 2 patient cases that highlight this are presented. Conclusions: Delayed surgical intervention in pediatric orbital trapdoor fractures increases the risk of delayed recovery and persistent diplopia. Other factors, such as the degree of muscle incarceration and necrosis and the surgeon's experience and skill, may, however, also influence the outcomes.

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Section: Discussionmentioning

confidence: 99%

“…This delayed recovery may be caused by the effect of muscle edema, hemorrhage, ischemia, muscle contusion, or scarring within and around the orbital fibrous sheath network. A second surgery will probably not improve this healing process 10,11…”

Section: Discussionmentioning

confidence: 99%

Pediatric Orbital Fractures: Outcomes in Relation to Time of Surgery

Gudnadottir

Hammarfjord

Johansson

et al. 2023

Journal of Craniofacial Surgery

View full text Add to dashboard Cite

show abstract

“…Even in patients with limited ocular movement, attention should be paid to conditions such as extraocular muscle palsy, ruptured globe, or retinal detachment that require postponement or avoidance of surgical treatment. 1 , 40 All the participants of this study were evaluated by an ophthalmologist to rule out those conditions.…”

Section: Discussionmentioning

confidence: 99%