1/23. Barotraumatic blowout fracture of the orbit.We report a rare case of a barotraumatic blowout fracture of the orbit. A 32-year-old woman presented with sudden swelling of the right orbital region after vigorous nose blowing. Computed tomography scan revealed a blowout fracture of the medial wall of the right orbit with orbital emphysema and herniation of the orbital soft tissue. She was treated with prednisolone and an antibiotic, and did not show diplopia or visual disturbance. Three different theories have so far been proposed to explain the mechanism of blowout fractures, globe-to-wall contact theory, hydraulic theory, and bone conduction theory. The present case indicates that blowout fractures of the orbit can be induced solely by a sudden change of pressure, thereby suggesting the validity of the hydraulic theory.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
2/23. Hemorrhagic cyst following remote alloplastic implantation for orbital floor fracture repair.Hemorrhagic cyst formation may occur within months or years following repair of orbital fractures with alloplastic materials. patients present with a sensation of pressure in the involved orbit, double vision, and globe displacement. Evaluation must rule out infectious, inflammatory, and vascular etiologies. Computerized tomography scans reveal a soft tissue density surrounding the alloplastic implant. drainage of the cyst and fibrous capsule, with excision of the capsule and removal of the alloplastic implant, is curative. This article presents three clinical cases, highlighting the evaluation and management of this postsurgical development. Use of the protocol described resulted in complete resolution of all clinical symptoms, and the CT scans were normal. As these materials will continue to be utilized, surgeons should be aware of this potential delayed complication and its management.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
3/23. Orbital emphysema during air travel: a case report.Orbital emphysema is a well-recognized complication of fractures involving the orbit. Commonly, this follows nose blowing and occurs in the subcutaneous tissues. A case of emphysema within the orbital cavity caused by the pressure changes during air travel is presented. The clinical picture was similar to that seen in retrobulbar haemorrhage and required early surgical intervention. Circumstances where patients at risk may be exposed to abnormal atmospheric pressures are highlighted and the management of the condition is discussed.- - - - - - - - - - ranking = 2keywords = pressure (Clic here for more details about this article) |
4/23. Orbital porencephalic cyst following penetrating orbitocranial trauma.In a 10-year-old boy an orbitocranial penetrating wound produced by an umbrella tip caused an orbital roof bone fragment to penetrate up to the anterior part of the third ventricle behind the left foramen of Monro. Hemorrhages and encephalomalacia developed along the trajectory of the fragment and subsequently a porencephalic cyst was formed at this site. Six months after the trauma, increased pressure developed in the left ventricular system due to obstructive hydrocephalus and consequently the porencephalic cyst herniated into the orbit through the orbital roof fracture, producing intermittent diplopia, left exophthalmos, and palpebral swelling. A ventriculo-peritoneal shunt led to shrinkage of the orbital cyst content and resolution of the symptoms.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
5/23. Tension pneumoorbitus.Posttraumatic tension orbitus developed in a young man causing subconjunctival emphysema and proptosis. Intraocular pressures were monitored as a means of indirectly measuring intraorbital pressure. The patient was serially examined for evidence of compressive optic neuropathy. Because of the possibility of orbital pressure increasing several hours from the time of injury, we recommend monitoring of these patients through intraocular pressure measurement and evaluation of the optic nerve for evidence of compression. Our findings, however, do support previous documentation that the intraocular pressure rise following orbital trauma with orbital emphysema is usually not of sufficient severity or duration to result in visual compromise.- - - - - - - - - - ranking = 5keywords = pressure (Clic here for more details about this article) |
6/23. Nasoethmoid orbital fractures. Current concepts and management principles.The proper management of nasoethmoid orbital fractures relies upon early accurate diagnosis and treatment. A surgical plan must be established after careful review of the physical examination and CT scans. Identification of the extent and type of fracture pattern determines the operative approach. Extended (wide) exposure, using craniofacial techniques, facilitates precise reduction and rigid fixation of all bone fragments. Transnasal reduction of the canthus-bearing central segment (medial orbital rim) is the critical operative maneuver required to achieve normal intercanthal distance. Immediate bone grafting replaces severely comminuted or missing bone fragments. The skin overlying the nasoethmoid area is carefully redraped by gentle pressure from padded external compression bolsters. These principles form the basis for superior aesthetic and functional results.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
7/23. Orbital emphysema following nose blowing as a sequel of a snowboard related head injury.A case of orbital emphysema as a sequel of a snowboard related head injury is reported. It is believed that a fracture of the medial orbital wall was caused by the increased intraorbital pressure when the patient hit his forehead on the snowy ground, allowing air to enter the orbit when he blew his nose. Wearing goggles may prevent this type of sports related injury.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
8/23. Bone from an orbital floor fracture causing an intraocular foreign body.PURPOSE: To describe the ophthalmoscopic and radiologic findings of a patient who sustained blunt orbital trauma. A piece of bone from the fractured orbital wall caused an intraocular foreign body. DESIGN: Case report. methods: An 18-year-old man underwent full ophthalmoscopic examination 1 week after sustaining blunt ocular trauma to the right eye while playing basketball. B-scan ultrasonography and computed tomography of the orbits were also performed. RESULTS: visual acuity, intraocular pressure, and anterior segment examination were normal. Funduscopic examination revealed a fragment of bone that had penetrated the sclera, choroid, and retina. A hole in the sclera was visible. No treatment was performed. Three months later, the patient had no ocular complaints or complications as a result of this injury. CONCLUSION: Bone from a patient's orbit may cause an intraocular foreign body that may be followed conservatively in certain circumstances.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
9/23. Management of combined frontonaso-orbital/skull base fractures and telecanthus in 355 cases.In regard to the multiple problems of reconstruction concerning this fracture pattern, we developed various methods to achieve optimal results. As various vital regions, apart from the nasoethmoidal fractures and aesthetics, are involved, the proposed classification has direct implication for the surgical procedure. Even in intracranial fragment dislocations, cerebral contusion, and elevated intracranial pressure, the subcranial approach, in contrast with the transfrontal access, enables early definitive management of the skull base and the external facial frame in a one-stage procedure. Another method, the symmetrical centripetal compression of the canthal ligaments and naso-orbital bone fragments, enables correct reduction of the telecanthus. The significant reduction of morbidity and complication rate to a minimum confirms the efficiency of our treatment modalities.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
10/23. adult medial orbital wall trapdoor fracture with missing medial rectus muscle.We report the case of a 28-year-old man presenting with a medial orbital wall trapdoor fracture with a missing medial rectus muscle. We believe this to be the first case report of an adult medial orbital wall trapdoor fracture. Trapdoor fractures most commonly occur in the pediatric population, and those involving the medial orbital wall generally occur in areas with less developed ethmoid air cells. Since the present case followed neither pattern, a different injury mechanism was considered. The ethmoid air cells in this case were well developed, which may have played an important role in the pathogenesis of this adult medial orbital wall trapdoor fracture. Based on our findings, we propose a possible mechanism for a medial orbital wall trapdoor fracture in an adult. The cellular frames enable the medial bone to shift just minimally, regardless of the high orbital pressure during a blow. The excess volume of the orbital content escapes into the cells through narrow cracks; therefore, after a blow, it cannot move back completely into the orbit. Consequently, it pushes the shifted bone towards the orbit, becoming trapped in a manner similar to that of a check-valve mechanism.- - - - - - - - - - ranking = 1keywords = pressure (Clic here for more details about this article) |
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