Ha AY, Mangham W, Frommer SA, Choi D, Klinge P, Taylor HO, Oyelese AA, Sullivan SR. Interdisciplinary Management of Minimally Displaced Orbital Roof Fractures: Delayed
Pulsatile Exophthalmos and Orbital Encephalocele.
Craniomaxillofac Trauma Reconstr 2016;
10:11-15. [PMID:
28210402 DOI:
10.1055/s-0036-1584395]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Accepted: 02/20/2016] [Indexed: 10/21/2022] Open
Abstract
Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. They are typically associated with severe mechanisms of injury and may be associated with significant neurologic or ophthalmologic compromise including traumatic brain injury and vision loss. Rarely, traumatic encephalocele or pulsatile exophthalmos may be present at the time of injury or develop in delayed fashion, necessitating close observation of these patients. In this article, we describe two patients with minimally displaced blow-in type orbital roof fractures that were later complicated by orbital encephalocele and pulsatile exophthalmos, prompting urgent surgical intervention. We also suggest a management algorithm for adult patients with orbital roof fractures, emphasizing careful observation and interdisciplinary management involving plastic surgery, neurosurgery, and ophthalmology.
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