Ossifying fibroma: a rare cause of orbital inflammation.

PURPOSE: To describe the clinical and radiologic features of 4 cases of ossifying fibroma affecting the orbit and to review the literature on orbital involvement by the tumor. METHODS: Small case series. RESULTS: Four patients (3 children and 1 adult) with ossifying fibromas invading the orbit were examined. Two of the 3 children were examined for ossifying fibromas on the orbital roof. One had the psammomatoid form of the disease and the other the trabecular variant. Despite striking differences in the histologic pattern and in the radiologic appearance of the lesions, both children displayed a significant degree of orbital inflammation mimicking orbital cellulitis. The third child and the adult patient had the orbit involved by trabecular ossifying fibromas invading the orbital floor. The tumor of the adult clearly originated in the maxilla, filled the maxillary sinus, and eroded the orbital floor. The tumor of the third child occupied the maxillary, ethmoid, and sphenoid sinuses. In both cases, the clinical presentation was painless eye dystopia and proptosis. CONCLUSIONS: Regardless of the histologic pattern (trabecular or psammomatoid), ossifying fibromas can induce a substantial degree of orbital inflammation in children and must be included in the differential diagnosis of acute orbital inflammation during childhood.

Epidemiology and management of orbital fractures.

PURPOSE OF REVIEW: Orbital fractures are usually associated with ocular and intracranial injuries. The recent literature on orbital fractures is analyzed with emphasis on epidemiology, assessment, and surgical management. RECENT FINDINGS: In most countries, traffic accidents are the leading cause of orbital fractures. Orbitozygomatic fractures are extremely frequent but rarely addressed in the ophthalmic literature. CT scanning remains the gold standard for assessing orbital fractures, especially with the new CT technology (multislice CT), which has improved the acquisition of coronal images of the orbit without the need for hyperextension of the neck. Several different surgical strategies are used to repair orbital fractures. Porous polyethylene implants continue to be approved by most surgeons. SUMMARY: Orbital fractures are usually part of more complex midfacial trauma. Depending on the main characteristics of the trauma, orbital fractures are managed by different specialists who adopt distinct surgical approaches. Taking into consideration that most complications of these fractures are related to the globe, oculoplastic surgeons in collaboration with other medical specialists are in a prime position to assess and manage these cases.