“…S everal patterns of orbital fat prolapse have been previously described, [1][2][3][4] some of which are clinically relevant. Intracranial fat prolapse has been associated with optic nerve compression in thyroid eye disease.…”
mentioning
confidence: 99%
“…6 Not infrequently, orbital fat prolapse may be posttraumatic. 3,4 Orbital fat prolapse may but does not necessarily occur in the setting of proptosis. In a small study of patients with proptosis with excess orbital fat, 7 obesity, Graves disease, and Cushing syndrome were found to represent the underlying disease processes.…”
BACKGROUND AND PURPOSE: A few patterns of orbital fat prolapse have been described. Some are associated with disease, and others may mimic a neoplasm. We have observed prolapse of orbital fat into the infratemporal fossa via the inferior orbital fissure on MR imaging. The clinical relevance of this finding, if any, is unknown. The purposes of this study were to describe the MR imaging appearance of orbital fat prolapse through the inferior orbital fissure, to estimate the prevalence of this finding, and to assess possible pathologic associations. MATERIALS AND METHODS: For this retrospective study of 228 orbital MR imaging examinations, 3 neuroradiologists independently assessed the presence of prolapse on high-resolution T1-weighted images. Discrepancies were resolved by consensus, and interobserver agreement was calculated. Patient demographics, indications for imaging, and pertinent clinical history were recorded. One-way analysis of variance and the Fisher exact test were used to assess possible associations between prolapse and specific patient characteristics. RESULTS: Orbital fat prolapse through the inferior orbital fissure was observed in 20/228 patients (9%). This finding was unilateral in 11 patients (55%) and bilateral in 9 patients (45%). There was no significant association with age, sex, obesity, Graves disease, hypercortisolism, prior orbital trauma, proptosis, or enophthalmos. Interobserver agreement was 90%. CONCLUSIONS: Prolapse of orbital fat into the infratemporal fossa via the inferior orbital fissure is a relatively common finding on orbital MR imaging that has no identified pathologic association. Neuroradiologists should recognize this finding so as not to report it as pathologic.
“…S everal patterns of orbital fat prolapse have been previously described, [1][2][3][4] some of which are clinically relevant. Intracranial fat prolapse has been associated with optic nerve compression in thyroid eye disease.…”
mentioning
confidence: 99%
“…6 Not infrequently, orbital fat prolapse may be posttraumatic. 3,4 Orbital fat prolapse may but does not necessarily occur in the setting of proptosis. In a small study of patients with proptosis with excess orbital fat, 7 obesity, Graves disease, and Cushing syndrome were found to represent the underlying disease processes.…”
BACKGROUND AND PURPOSE: A few patterns of orbital fat prolapse have been described. Some are associated with disease, and others may mimic a neoplasm. We have observed prolapse of orbital fat into the infratemporal fossa via the inferior orbital fissure on MR imaging. The clinical relevance of this finding, if any, is unknown. The purposes of this study were to describe the MR imaging appearance of orbital fat prolapse through the inferior orbital fissure, to estimate the prevalence of this finding, and to assess possible pathologic associations. MATERIALS AND METHODS: For this retrospective study of 228 orbital MR imaging examinations, 3 neuroradiologists independently assessed the presence of prolapse on high-resolution T1-weighted images. Discrepancies were resolved by consensus, and interobserver agreement was calculated. Patient demographics, indications for imaging, and pertinent clinical history were recorded. One-way analysis of variance and the Fisher exact test were used to assess possible associations between prolapse and specific patient characteristics. RESULTS: Orbital fat prolapse through the inferior orbital fissure was observed in 20/228 patients (9%). This finding was unilateral in 11 patients (55%) and bilateral in 9 patients (45%). There was no significant association with age, sex, obesity, Graves disease, hypercortisolism, prior orbital trauma, proptosis, or enophthalmos. Interobserver agreement was 90%. CONCLUSIONS: Prolapse of orbital fat into the infratemporal fossa via the inferior orbital fissure is a relatively common finding on orbital MR imaging that has no identified pathologic association. Neuroradiologists should recognize this finding so as not to report it as pathologic.
“…The indications to orbital repair are still unclear; absolute indications to surgical repair are as follows: a clinically evident enophthalmos and/or hypophthalmos, a severe restriction of ocular motility with CT evidence of muscle entrapment or incarceration of periorbital soft tissue, a “white eye blowout” fracture in children or young adults with strict restriction of ocular motility and vagal symptoms, compartment syndromes (superior orbital fissure and orbital apex syndromes) needing urgent surgical decompression. Relative indications involve the presence of orbital floor defects > 50% of the orbital floor or an affected area of > 1 cm 2 , and persistent diplopia due to entrapment or fibrosis of the extra orbital muscles [ 16 ].…”
Section: Introductionmentioning
confidence: 99%
“…Surgical management consists of the removal of displaced bone fragments and internal fixation of the fracture through the positioning of mesh materials to restore the original orbital volume and morphology (Fig. 1 ) [ 16 ]. Fig.…”
Computed tomography (CT) is considered the gold standard technique for the assessment of trauma patients with suspected involvement of the eye and orbit. These traumas can result in dramatic consequences to visual function, ocular motility, and aesthetics. CT is a quick and widely available imaging modality, which provides a detailed evaluation of the orbital bony and soft tissue structures, an accurate assessment of the globes, and is used to guide the patients’ treatment planning. For a timely and accurate diagnosis, radiologists should be aware of fracture patterns and possible associated complications, ocular detachments and hemorrhages, and different appearances of intraorbital foreign bodies. This educational review aims to describe all post-traumatic orbital abnormalities that can be identified on CT, providing a list of tips and a diagnostic flowchart to help radiologists deal with this complex condition.
“…Furthermore, among orbital fractures, the orbital floor is the most commonly involved wall due to its thin bony structure [3,4,6]. Due to the high risk of ocular complications such as extraocular movement limitation and diplopia, in the presence of orbital floor fractures (OFFs) [7,8], early diagnosis of OFFs is necessary during the evaluation of head trauma at emergency departments.…”
Background: Patients with head trauma may have concomitant orbital floor fractures (OFFs). The objective of our study was to determine the specific CT findings and investigate the diagnostic performance of head CT in detecting OFFs. Methods: We analyzed 3534 head trauma patients undergoing simultaneous head and facial CT over a 3-year period. The clinical data and specific head CT findings between patients with and without OFFs were compared. Results: In our cohort, 198 patients (5.6%) had OFFs visible on CT. On head CT, orbital floor discontinuity, gas bubbles entrapped between floor fragments, inferior extraconal emphysema, and maxillary hemosinus (MHS) were more commonly observed among patients with OFFs (p < 0.001). The absence of MHS had a high negative predictive value (99.7%) for excluding OFFs. Among the different types of MHS, the pattern showing high-attenuation opacity mixed with mottled gas had the highest positive predictive value (69.5%) for OFFs and was the only independent predictor of OFFs after adjusting for the other CT variables in all patients with MHS. Conclusion: Head CT may serve as a first-line screening tool to detect OFFs in head trauma patients. Hence, unnecessary facial CT and additional radiation exposure may be reduced.
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