Medial wall fracture- induced pneumo-orbita mimicking inferior rectus entrapment.
The authors report 2 patients who experienced medial wall blowout fractures. Both patients presented with significant restriction of upgaze, mild proptosis, and crepitus of the upper lid. Computed tomography revealed significant pneumo-orbita filling the superior orbit with inferior displacement of the muscle cone and subcutaneous emphysema. No floor fractures were seen in either patient, but in both cases, the medial wall was breached and was almost certainly the source of the intraorbital air. Patients were managed conservatively, and the vertical gaze deficiencies resolved after 3 to 5 days. Large amounts of intraorbital and extraorbital air in the absence of a floor fracture can imitate inferior rectus entrapment and could potentially lead to unnecessary surgical intervention.
Burt
Benjamin
B
Greenlane Clinical Centre, Victoria, Australia; Bendigo Eye Clinic, Bendigo 3550, Victoria, Australia.
Jamieson
Michael
M
Sloan
Brian
B
D000328:Adult; D003937:Diagnosis, Differential; D005128:Eye Diseases / Q000175:diagnosis*; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications; D006801:Humans; D008297:Male; D009801:Oculomotor Muscles; D009915:Orbit / Q000000981:diagnostic imaging / Q000293:injuries*; D009917:Orbital Fractures / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000209:etiology; D013352:Subcutaneous Emphysema / Q000000981:diagnostic imaging / Q000209:etiology; D014057:Tomography, X-Ray Computed; D055815:Young Adult