Radiological signs of periorbital trauma - the Singapore experience.
OBJECTIVE
To describe the radiological signs and demographic characteristics of patients who suffered facial trauma in South-East Asia.


METHODS
This is a retrospective cross-sectional study of a 399 patients who presented with facial trauma over a 2-year period in a tertiary referral centre in South-East Asia. Patients with available CT scan films were included. Demographics, bony and soft tissue radiology characteristics were analyzed.


RESULTS
Male to female ratio was 320 (80%):79 (20%). Most of the facial trauma was due to Road Traffic Accident. Of 399 patients, 273 (68%) showed radiological signs of bone or soft tissue trauma. Of these 273 patients, left to right side involvement was 114 (41.7%) / 82 (30.03%), and 77 (28.2%) had bilateral involvement. Floor was the most involved wall (229[83.8%]) and the most involved rim was the inferior rim (164[60.07%]). There were 39 (14.2%) patients with blowout fracture. Bony nasolacrimal duct was broken in 56 (20.5%) patients. Optic canal fracture was found in 7 (2.5%) patients and it was associated with roof and superior rim fracture (P-values were 0.016, 0.046, respectively). Thirty-three (12.08%) patients had radiological signs of extraocular muscle involvement. Traumatic intracranial signs were associated with roof and superior rim fractures (P < 0.001 for both).


CONCLUSIONS
Floor and inferior rim were the most affected orbital structures in facial trauma. We described radiological risk factors association with optic canal, NLD fracture and intracranial involvement. We described extraocular muscle morphological signs, which could alert to the possibility of orbital floor fracture in equivocal cases.
Ophthalmology Department, National University Health System, Singapore. ramousa@yahoo.com
Radwan
R
Almousa
Shantha
S
Amrith
Amir H
AH
Mani
Shen
S
Liang
Gangadhara
G
Sundar
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003430:Cross-Sectional Studies; D005147:Facial Bones / Q000000981:diagnostic imaging* / Q000293:injuries; D005260:Female; D017102:Fracture Healing / Q000502:physiology; D006801:Humans; D015994:Incidence; D015601:Injury Severity Score; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009915:Orbit / Q000000981:diagnostic imaging* / Q000293:injuries*; D009917:Orbital Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000628:therapy; D012189:Retrospective Studies; D017678:Sex Distribution; D012846:Singapore / Q000453:epidemiology; D018709:Statistics, Nonparametric; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult