Interdisciplinary Management of Minimally Displaced Orbital Roof Fractures: Delayed Pulsatile Exophthalmos and Orbital Encephalocele

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 en...

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Bibliographic Details
Published in:Craniomaxillofacial trauma & reconstruction 2017-03, Vol.10 (1), p.11-15
Main Authors: Ha, Austin Y., Mangham, William, Frommer, Sarah A., Choi, David, Klinge, Petra, Taylor, Helena O., Oyelese, Adetokunbo A., Sullivan, Stephen R.
Format: Article
Language:English
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Summary: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.
ISSN:1943-3875
1943-3883
DOI:10.1055/s-0036-1584395