Isolated Medial Orbital Wall Fracture Associated with Enophthalmos in a Paediatric Patient: An Unusual Presentation

Giannakouras, Panagiotis; Pollalis, Georgios; Tsina, Efthymia

doi:10.1159/000486275

Cited by 4 publications

(4 citation statements)

References 17 publications

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“…In such cases, posttraumatic increase in orbital volume is cited to be the cause of enophthalmos. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

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Isolated Medial Orbital Wall Fracture Correction with Revision of Levator Plication - A Case Report

Balaji

2021

Annals of Maxillofacial Surgery

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The Rationale: Treatment options for isolated medial orbital wall fractures (IMOWF) vary. In young and favourable situations, most of the times, the fracture is left to heal spontaneously. If not properly monitored, it may improperly fuse causing poor form and function. Patient Concerns: A 24-year-old male presented for correction of his sunken left eye. The patient had a blunt trauma 10 years back and had left upper eyelid as well as ptosis correction elsewhere. Since that surgery, the patient noticed that the eye had been slowly and progressively “sinking” with time. Diagnosis: An IMOWF with periorbital fat entrapment and detachment of levator palpebrae superioris was identified. Treatment and Outcome: The fracture site was reached via a transcaruncular approach, the fracture corrected and orbital defect corrected with a mesh. One week later, in a second-stage surgery, under local anaesthesia, the muscle was repositioned. Recovery was uneventful and the desired aesthetic-functional results were achieved. Take-Away Lessons: An untreated IMOWF in young adolescents could persist and subsequent growth could amplify the enophthalmos. A careful diagnosis and treatment is warranted.

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“…In such cases, posttraumatic increase in orbital volume is cited to be the cause of enophthalmos. [ 5 ]…”

Section: Discussionmentioning

confidence: 99%

“…In addition, residual enophthalmos could be accentuated when there is the potential growth of the ocular bone complex. [ 3 4 5 ] The aim of this manuscript is to report an incidence of paediatric IMOWF presenting with enophthalmos 10 years later.…”

Section: B Ackgroundmentioning

confidence: 99%

Isolated Medial Orbital Wall Fracture Correction with Revision of Levator Plication - A Case Report

Balaji

2021

Annals of Maxillofacial Surgery

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“…Although pediatric facial trauma is overall rare, orbital fractures are common, ranging from 20 ] did not find a proportionate decrease in pediatric ocular trauma. In addition, although there is evidence for potential increase in incidence of intimate partner violence during the COVID pandemic [6 change in child abuse rates in the pediatric trauma population.…”

Section: Epidemiologymentioning

confidence: 99%

“…Patients may present with orbital crepitus due to fracture into the sinuses [19]. Enophthalmos is possible but less common [20]. Although rare, it is possible for medial orbital fractures to have entrapment (Fig.…”

Section: Medialmentioning

confidence: 99%

Pediatric orbital fractures

Coviello

Williams

Sivam

2023

Current Opinion in Otolaryngology &Amp; Head &Amp; Neck Surgery

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Purpose of review The aim of this study was to summarize current evidence on the clinical presentation, evaluation, and management of pediatric orbital fractures. Recent trends in management strategies as well as emerging surgical techniques for pediatric orbital fracture repair are presented. Recent findings Although somewhat limited, growing bodies of evidence support a conservative approach with close follow up in pediatric orbital fractures. For those patients necessitating surgical repair, resorbable implants are increasingly preferred given their lack of donor site morbidity and a minimal impact on the developing craniofacial skeleton. There are emerging data reporting the use of three-dimensional (3D) printing-assisted approaches and intraoperative navigation; however, more research is needed to assess their applicability in the pediatric population. Summary There are few studies with large patient cohorts and long-term follow up given the rare incidence of pediatric orbital fractures, which restricts the generalizability of research on the topic. The studies available increasingly suggest that fractures without clinical evidence of entrapment can be managed conservatively with close follow up. A variety of reconstructive implants are available for those fractures necessitating repair. Donor site morbidity, availability, and need for additional procedures should all be factored into the reconstructive decision-making process.

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