The Incidence of Traumatic Optic Neuropathy Associated With Subtypes of Orbital Wall Fracture

Sakong, Yong; Chung, Kyu Jin; Kim, Yong-Ha

doi:10.1097/scs.0000000000008007

Cited by 3 publications

(6 citation statements)

References 24 publications

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“…Our ndings are similar to those of previous studies by Natarajan et al and Sakong et al, who found that the highest incidence of TON was noted with lateral orbital wall involvement, and the occurrence of TON was notably elevated at 1.796% in cases involving the lateral wall (1,13). In our study, MVA was the most common injury mechanism reported in 46 patients, compared with traumatic injuries reported in 23 patients.…”

Section: Discussionsupporting

confidence: 92%

“…Traumatic Optic Neuropathy (TON) is an optic nerve injury resulting from physical trauma, leading to serious outcomes like diminished vision or total blindness (13). Between 0.7% and 10.8% of facial bone fractures result in vision impairment (14).…”

Section: Discussionmentioning

confidence: 99%

“…In patients with TON, the most reported fracture was lateral wall fracture with an ER of 40.9% (95% CI: 1.2 to 87.6%)with considerable heterogeneity (I2 = 84.4 %, P < 0.001), superior wall fracture with an ER of 34% (95% CI: 15.6 to 59%) with considerable heterogeneity (I2 = 84.4%, P < 0.001), inferior wall fracture with an ER of 32.5% (95% CI:17 to 53%) with considerable heterogeneity (I2 = 76.7%, P = 0.005), and medial wall fracture with an ER of 24.8% (95% CI: 14 to 40%) with considerable heterogeneity (I2 = 63%, P = 0.044) (13). Further details can be seen in Figure 3.…”

Section: Features Of Orbital Wall Fractures In Patients With Tonmentioning

confidence: 99%

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Incidence of Traumatic Optic Neuropathy Associated with Subtypes of Orbital Wall Fracture: A Systematic Review

Alshammari,

AlRajhi,

AlNojaidi

et al. 2023

Preprint

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Background: Traumatic optic neuropathy (TON) is a rare condition with serious consequences. One common cause of TON is orbital wall fracture, which can occur at any site. This study aimed to report the incidence of TON in orbital wall fractures. Materials and Methods: A systematic search of Medline, Scopus, and the Directory of Open Access Journals (DOAJ) was conducted. The following terms were used: (traumatic optic neuropathy OR blindness) AND (craniofacial trauma OR facial fractures OR fracture pattern OR orbital wall fracture OR Visual field orbital wall fractures) AND (Visual acuity OR Visual evoked potential) AND (Mega-dose steroid therapy OR corticosteroids). This review encompassed both Randomized Controlled Trials (RCTs) and observational investigations, comprising both prospective and retrospective studies. Results: Four studies met our inclusion criteria with 2720 patients included in this study. Most of the patients were males (n = 2175, 80%). A total of 3791 orbital wall fracture subtypes were reported in the included patients. Of them, 1522 patients had multiple fractures. The highest incidence of fracture was floor fracture, with an Event Rate (ER) of 42.2%, followed by lateral fracture (ER = 37.9%), roof fracture (ER = 36.2%), and medial fracture with ER (29%). Motor vehicle accidents were the most common injury mechanism reported in 46 patients, compared with traumatic injuries reported in 23 patients. Conclusion: Lateral and superior orbital wall fractures were the most common orbital fractures in patients with TON. Periorbital hematoma and subconjunctival hemorrhage were the most frequently reported complications. Hence, ophthalmologists treating patients with TON should prepare radiological assessments and consider the surrounding structures to prevent damage to other structures.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Section: Features Of Orbital Wall Fractures In Patients With Tonmentioning

confidence: 99%

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Incidence of Traumatic Optic Neuropathy Associated with Subtypes of Orbital Wall Fracture: A Systematic Review

Alshammari,

AlRajhi,

AlNojaidi

et al. 2023

Preprint

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“…These potentially disfiguring midface fractures comprise ~10% to 20% of all facial fractures and predominantly affect males aged 20 to 29 years who have sustained high-impact injury 2,3. Importantly, the traumatic etiology of Le Fort fractures frequently yields additional concomitant injuries, including intracranial or cervical spine damage, airway complications, and ophthalmologic injury 4–7. Furthermore, Le Fort fractures may present in the setting of panfacial fractures, culminating in a difficult challenge to the reconstructive surgeon given the lack of stable bone and obliteration of anatomic landmarks 8,9…”

mentioning

confidence: 99%

“…2,3 Importantly, the traumatic etiology of Le Fort fractures frequently yields additional concomitant injuries, including intracranial or cervical spine damage, airway complications, and ophthalmologic injury. [4][5][6][7] Furthermore, Le Fort fractures may present in the setting of panfacial fractures, culminating in a difficult challenge to the reconstructive surgeon given the lack of stable bone and obliteration of anatomic landmarks. 8,9 Given the reconstructive complexity associated with Le Fort fracture management, operative approaches to Le Fort fractures have been well detailed within the literature.…”

mentioning

confidence: 99%

Risk Factors for Acute Postoperative Complications Following Operative Management of Le Fort Fractures—A NSQIP Study

Matabele

Seitz

Doan

et al. 2023

Journal of Craniofacial Surgery

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Introduction: Le Fort fractures comprise a pattern of complex midfacial fractures that arise secondarily to craniofacial trauma. Although management of these fractures has been detailed within the literature, there is a paucity of research examining postoperative outcomes after surgical repair. The primary aim of this study is to assess patient outcomes after operative management of Le Fort fractures, and examine factors influencing the risk for developing postoperative complications, through utilization of the ACS-NSQIP database. Methods: The American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database was queried for cases recorded between 2012 and 2019 with International Classification of Disease (ICD)-9 and ICD-10 codes corresponding to Le Fort fractures. Patient demographics, clinical variables, and postoperative variables were recorded. Logistic regression analysis was conducted to identify independent risk factors for postoperative complications. Results: Identification of cases with appropriate ICD codes, and exclusion of those with missing data, yielded 562 patients for analysis. There were no cases of minor complications and 14 cases of severe complications (3 cases of wound dehiscence, 3 cases of transfusion requirement, 1 case of failure to wean from the ventilator for more than 48 h, 1 pulmonary embolism, and 8 cases of reoperation), corresponding to an overall complication rate of 2.49%. Logistic regression analysis revealed steroid use as an independent predictor of severe postoperative complications (OR = 13.73, 95% CI: 1.08-128.02, P = 0.02). Conclusion:The present study is the first to conduct a risk factor analysis of patients with Le Fort fractures using the ACS-NSQIP national database. The overall postoperative complication rate was 2.49%, with 14 cases of complications recorded in 8 years. Although this may suggest that surgical management of Le Fort fractures is generally well-tolerated, it should be noted that this problem is frequently associated with other severe injuries of the head and neck that may influence patient prognosis. Given this, further analysis would benefit from a larger patient cohort and longer postoperative data as the ACS-NSQIP database only records outcomes within 30 days.

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Analysis of risk factors for patients with traumatic optic neuropathy and comparison of visual outcomes of management strategies

Chen,

Chou

et al. 2024

Journal of Plastic, Reconstructive & Aesthetic Surgery

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The Incidence of Traumatic Optic Neuropathy Associated With Subtypes of Orbital Wall Fracture

Cited by 3 publications

References 24 publications

Incidence of Traumatic Optic Neuropathy Associated with Subtypes of Orbital Wall Fracture: A Systematic Review

Incidence of Traumatic Optic Neuropathy Associated with Subtypes of Orbital Wall Fracture: A Systematic Review

Risk Factors for Acute Postoperative Complications Following Operative Management of Le Fort Fractures—A NSQIP Study

Analysis of risk factors for patients with traumatic optic neuropathy and comparison of visual outcomes of management strategies

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