title: Different onset pattern of oculocardiac reflex in pediatric medial wall blowout fractures.
abstract: OBJECTIVE
  We report the 2 pediatric patients who had radiographic confirmation of a rare case of medial orbital wall "trapdoor" fracture with extraordinary symptoms of oculocardiac reflex (OCR).
  
  
  METHODS
  This was a small interventional case series.
  
  
  RESULTS
  This is the retrospective report of 2 boys (13 and 10 years old) who developed diplopia, pain, nausea/vomiting, and general malaise following blunt trauma. However, the onset pattern of OCR was absolutely different: delayed onset of OCR just following therapeutic forced duction test to treat the orbital content herniation in the first case and a sudden onset after injury in the second case. In both cases, urgent surgery led to complete normalization of ocular motility.
  
  
  CONCLUSIONS
  Prompt diagnosis and proper treatment are critical to maximize clinical outcome for this rare and critical trauma.
authors.affiliation: From the Department of Plastic Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan.
authors.forename: Masaaki
authors.initials: M
authors.lastname: Kosaka
authors.forename: Tadayoshi
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Kohsaku
authors.initials: K
authors.lastname: Yamamichi
authors.forename: Yuri
authors.initials: Y
authors.lastname: Yamashiro
mesh_terms: D000293:Adolescent; D002648:Child; D004172:Diplopia / Q000209:etiology; D005133:Eye Movements / Q000502:physiology; D005500:Follow-Up Studies; D006547:Hernia / Q000209:etiology; D006801:Humans; D008297:Male; D009325:Nausea / Q000209:etiology; D009801:Oculomotor Muscles / Q000293:injuries; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000503:physiopathology* / Q000601:surgery; D012024:Reflex, Oculocardiac / Q000502:physiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014839:Vomiting / Q000209:etiology; D014949:Wounds, Nonpenetrating / Q000503:physiopathology / Q000601:surgery