ABSTRACT
@#A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haematoma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe repositioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.
ABSTRACT
PURPOSE: Globe displacement due to a blowout fracture is a rare clinical phenomenon. The authors present reduction of a globe displacement to the maxillary sinus due to trauma suffered in a fall and the reconstruction of a large defect left in the medial and inferior orbit. METHODS: A 39-year-old male patient was unable to open his left eye after being struck on the periorbital area by a metal edge. Laceration was not noted in that area but we were unable to observe the intraorbital globe. A facial computed tomography (CT) scan showed that the globe was displaced through the maxillary sinus. A transconjunctival approach was used to access the infraorbital margin and the globe entrapped in the inferior margin of the orbit was successfully reduced. A large defect in the medial and inferior orbit was reconstructed using a graft from the iliac bone. RESULTS: In 5 months after the operation, no atrophy of the globe was seen. Both sides retained a similar shape. A satisfactory functionality outcome in terms of improved extraocular muscle movement, and a satisfactory aesthetical outcome were achieved. CONCLUSION: The authors report the reduction of a globe displaced to the maxillary sinus following a fall and the reconstruction of the large defect left in the medial and inferior orbit.
Subject(s)
Adult , Humans , Male , Atrophy , Lacerations , Maxillary Sinus , Orbit , TransplantsABSTRACT
We experienced a rare case of traumatic displacement of the globe into the ethmoid sinus. A 66-year-old man sustained trauma of the right eye and orbit, which resulted in displacement of the globe into the ethmoid sinus. One day after injury, surgery was performed to restore the intact globe into position within the orbit. Ten days after the operation, light perception was noticed only when transillumination was placed into orbit. Trace test undergone 45 days after the operation, no sight were measured from right eye, and the movement of right eyeball was not possible in any direction. We believe that the nerve and extraocular muscles were severed against the floor of the orbit or severely traumatized as the globe entered the ethmoid sinus. This case is very rare and never reported in Korea. We treated by replacing the globe in the orbit surgically and reconstructing the orbital floor with acurate diagnosis by the Computed Tomography(CT) scan.