title: Surgical management of posttraumatic intraorbital hematoma.
abstract: Retrobulbar hematoma is a rare condition but represents a diagnostic and therapeutic emergency. It occurs in between 0.3% and 3.5% of facial traumas and can be caused by direct or indirect injury of the orbit; they can be classified into intraorbital and subperiosteal hematoma. We describe 4 different cases of posttraumatic retrobulbar hematoma treated at the Unit of Maxillofacial Surgery of the Novara Major Hospital between January 2005 and December 2009, each different from the others for morphologic aspects, and we discuss its diagnosis and management. Surgery decompression of the orbit is recommended when visual deficit arises and when there is no response to pharmacologic therapy. Several techniques for orbital decompression have been proposed. The lateral canthotomy and/or the inferior cantholysis are the 2 techniques most practiced. Anterior-chamber paracentesis is effective, but it is rarely indicated for frequent complications such as cataract formation, herniation of the iris, infection, and trauma to the canal of Schlemm. Other procedures including transantral ethmoidectomy, transantral sphenoidectomy, and transfrontal craniotomy are described.
authors.affiliation: Department of Maxillo-Facial Surgery, Azienda Ospedaliera Maggiore della Carità, University of Piemonte Orientale Amedeo Avogadro, Novara, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: Brucoli
authors.forename: Francesco
authors.initials: F
authors.lastname: Arcuri
authors.forename: Mariangela
authors.initials: M
authors.lastname: Giarda
authors.forename: Rodolfo
authors.initials: R
authors.lastname: Benech
authors.forename: Arnaldo
authors.initials: A
authors.lastname: Benech
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002648:Child; D003399:Craniotomy / Q000379:methods; D019299:Decompression, Surgical / Q000379:methods; D003907:Dexamethasone / Q000627:therapeutic use; D004322:Drainage; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006406:Hematoma / Q000601:surgery*; D006801:Humans; D008297:Male; D008440:Maxillary Fractures / Q000150:complications; D008775:Methylprednisolone / Q000627:therapeutic use; D009915:Orbit / Q000293:injuries* / Q000601:surgery; D009917:Orbital Fractures / Q000150:complications; D019315:Retrobulbar Hemorrhage / Q000601:surgery*; D014786:Vision Disorders / Q000209:etiology; D014792:Visual Acuity / Q000502:physiology; D015051:Zygomatic Fractures / Q000150:complications
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D008775:Methylprednisolone