medigraphic.com
ISSN 0185-3252 (Print)
Revista de la Asociación Médica del Centro Médico ABC

2020, Number 4

<< Back Next >>

An Med Asoc Med Hosp ABC 2020; 65 (4)

Clinical description and management of patients with orbital trauma

Olvera MO, García FAN, Schiappapietra GJM, Pinto ?CI, Rodríguez CLN, Rodríguez CL

Language: Spanish
References: 22
Page: 255-261
PDF size: 366.71 Kb.


ABSTRACT

Introduction: Ophthalmological examination is critical in the initial evaluation of patients with craniofacial trauma. The knowledge of the orbital, periocular, ocular anatomy; and the suspicion of hidden lesions are basic to reestablish proper anatomy and function. Objective: To describe the clinical characteristics of patient’s whit orbital trauma for the early recognition of serious injuries. Material and methods: Descriptive, retrospective, and cross-sectional study, that included records of patients with orbital, periorbital and ocular trauma. We analyzed demographic data, mechanism, type and site of trauma, clinical and imaging data, and association with injuries to the periocular an ocular area. Results: Eighteen patients were referred to orbit and oculoplastic, age 2 to 77 years. 92.3% had blunt orbital trauma. 7.7% penetrating eyelid trauma. 20% presented a fracture of floor of the orbit, fracture (95% blowout fractures). 5% with a lacrimal compromise, 69% some involvement of the eyeball, and vision compromise in 58%. Only 7.7% required hospitalized. 20% were requested computed tomography. One patient with penetrating trauma to the eyelid and severe injury to the eyeball was eviscerated. One patient with an orbito-palpebral foreign body. None patient with neurological damage. Everyone received steroids and oral pain relievers. Oral antibiotics was only use in one patient. All were prescribed topical ophthalmic treatment. An IBMS SPSS Statistics V21.0 package was used. Conclusions: Proper management is crucial for prognosis, after systemic stabilization, exhaustive clinical history is made, investigating the mechanism, the time of evolution and the previously established management, a complete ophthalmological and orbital exploration. In cases of suspected bone or intraorbital tissue lesions, request imaging studies.


REFERENCES

  1. Cepela MA, George CE. Orbital trauma. Curr Opin Ophthalmol. 1997; 8 (5): 64-69.

  2. Go JL, Vu VN, Lee KJ, Becker TS. Orbital trauma. Neuroimaging Clin N Am. 2002; 12 (2): 311-324.

  3. Roth FS, Koshy JC, Goldberg JS, Soparkar CN. Pearls of orbital trauma management. Semin Plast Surg. 2010; 24 (4): 398-410.

  4. Gönül E, Erdo?an E, Ta?ar M, Yeti?er S, Akay KM, Düz B et al. Penetrating orbitocranial gunshot injuries. Surg Neurol. 2005; 63 (1): 24-30; discussion 31.

  5. Felding UNA. Blowout fractures - clinic, imaging and applied anatomy of the orbit. Dan Med J. 2018; 65 (3): B5459.

  6. Erdmann D, Follmar KE, Debruijn M, Bruno AD, Jung SH, Edelman D et al. A retrospective analysis of facial fracture etiologies. Ann Plast Surg. 2008; 60 (4): 398-403.

  7. Ahmad F, Kirkpatrick NA, Lyne J, Urdang M, Waterhouse N. Buckling and hydraulic mechanisms in orbital blowout fractures: fact or fiction? J Craniofac Surg. 2006; 17 (3): 438-441.

  8. Morris C, Tiwana PS. Diagnosis and treatment of midface injuries. Chapter 17. In: Fonseca R, editor. Oral and maxilofacial trauma. 4th edition. St Louis, MO: Saunders; 2013. pp. 416-450.

  9. Shin JW, Lim JS, Yoo G, Byeon JH. An analysis of pure blowout fractures and associated ocular symptoms. J Craniofac Surg. 2013; 24 (3): 703-707.

  10. Song YS, Yokota H, Ito H, Yoshida A. Temporal posttraumatic limited ocular movement with suspected trapdoor fracture. Clin Ophthalmol. 2014; 8: 1535-1538.

  11. Solís BA. Abordaje inicial del trauma ocular en el I nivel de atención. Rev Med Cos Cen. 2011; 68 (598): 301-306.

  12. Fulcher TP, McNab AA, Sullivan TJ. Clinical features and management of intraorbital foreign bodies. Ophthalmology. 2002; 109 (3): 494-500.

  13. Alonso-Martín A, Bengoa-González A. Actuación en urgencias ante un traumatismo orbitario. Boletín de la Soc Oftalmo de Madrid. 2018; 58.

  14. Pérez-Llanes A, Cárdenas-Pérez FY, Hernández-Sánchez Y, Estarada-Amador B, Gómez-Cabrera C, Agramonte-Centelles I. Presentación de dos casos de traumatismo palpebral severo. Rev Cub Oftal. 2012; 25 (2): 336-341.

  15. Long JA. Tann TM. Eyelid and lacrimal trauma. In: Kuhn F, Pieramici D. Ocular trauma. Principles and practice. New York: Thieme; 2008. V: 373-382.

  16. Poon A, McCluskey PJ, Hill DA. Eye injuries in patients with major trauma. J Trauma. 1999; 46 (3): 494-499.

  17. Kuhn F, Morris R, Witherspoon CD, Mann L. Epidemiology of blinding trauma in the United States Eye Injury Registry. Ophthalmic Epidemiol. 2006; 13 (3): 209-216.

  18. Betts AM, O’Brien WT, Davis BW, Youssef OH. A systematic approach to CT evaluation of orbital trauma. Emerg Radiol. 2014; 21 (5): 511-513.

  19. Bord SP, Linden J. Trauma to the globe and orbit. Emerg Med Clin North Am. 2008; 26 (1): 97-123, vi-vii.

  20. Ashar A, Kovacs A, Khan S, Hakim J. Blindness associated with midfacial fractures. J Oral Maxillofac Surg. 1998; 56 (10): 1146-1150; discussion 1151.

  21. Sale-Higgins S, Pedraza-Alarcón R, Pinzón-Navarro M. Manejo quirúrgico de las fracturas orbitarias. Repertorio de Medicina y Cirugía. 2003; 12 (3): 128-133.

  22. Araoz-Medina V. Lesiones óculo-orbitarias en pacientes con traumatismo craneofacial. Rev Mex Oftalmol. 2005; 79 (3): 155-158.




2020     |     www.medigraphic.com