Superior orbital fissure syndrome after repair of maxillary and naso-orbito-ethmoid fractures: a case study.
OBJECTIVE
The superior orbital fissure syndrome results from damage to the nerves passing through the superior orbital fissure. In the present case, the superior orbital fissure syndrome developed after repair of facial bone fractures, although the symptoms were not observed before surgery and no obvious cause was found. To investigate the aetiology of this syndrome, we examined the superior orbital fissure anatomically.


METHODS
We measured the width of superior orbital fissure on the horizontal plane including the optic canal using the computed tomography (CT) scans of other patients and cadavers.


RESULTS
The results indicated that the width was 3.73+/-1.64 mm in the CT scans of patients and 3.21+/-1.09 mm in the cadavers. There was no significant difference between the width in the CT scans and cadavers. The width in the present patient on the affected side was 1.6mm, that is relatively narrow.


CONCLUSIONS
After operation, narrow superior orbital fissure may reduce the tolerance to compression of the nerves by oedema. We consider the narrow superior orbital fissure as a risk factor for superior orbital fissure syndrome. When the superior orbital fissure is congenitally narrow, the surgeons should try to avoid excessive pulling of the bone fragment and compression of the orbital tissue during repair of the facial bone fractures.
Fujiwara
Toshihiro
T
Department of Plastic Surgery, Osaka University, Graduate School of Medicine, Osaka, Japan. fujiwara@psurg.med.osaka-u.ac.jp
Matsuda
Ken
K
Kubo
Tateki
T
Tomita
Koichi
K
Yano
Kenji
K
Hosokawa
Ko
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D020209:Cranial Nerve Injuries / Q000175:diagnosis / Q000209:etiology*; D005147:Facial Bones / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery; D005260:Female; D005592:Fracture Fixation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009408:Nerve Compression Syndromes / Q000000981:diagnostic imaging / Q000209:etiology*; D012887:Skull Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D013100:Sphenoid Bone / Q000000981:diagnostic imaging / Q000473:pathology; D014057:Tomography, X-Ray Computed; D055815:Young Adult