title: Orbital apex disorders: a case series.
abstract: Orbital apex syndrome is an uncommon disorder characterized by ophthalmoplegia, proptosis, ptosis, hypoesthesia of the forehead, and vision loss. It may be classified as part of a group of orbital apex disorders that includes superior orbital fissure syndrome and cavernous sinus syndrome. Superior orbital fissure syndrome presents similarly to orbital apex syndrome without optic nerve impairment. Cavernous sinus syndrome includes hypoesthesia of the cheek and lower eyelid in addition to the signs seen in orbital apex syndrome. While historically described separately, these three disorders share similar causes, diagnostic course, and management strategies. The purpose of this study was to report three cases of orbital apex disorders treated recently and to review the literature related to these conditions. Inflammatory and vascular disorders, neoplasm, infection, and trauma are potential causes of orbital apex disorders. Management is directed at the causative process. The cases described represent a rare but important group of conditions seen by the maxillofacial surgeon. A review of the clinical presentation, etiology, and management of these conditions may prompt timely recognition and treatment.
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: R E
authors.initials: RE
authors.lastname: Warburton
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: C C D
authors.initials: CC
authors.lastname: Brookes
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
authors.forename: B A
authors.initials: BA
authors.lastname: Golden
authors.affiliation: Department of Oral and Maxillofacial Surgery, School of Dentistry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA. Electronic address: tim_turvey@unc.edu.
authors.forename: T A
authors.initials: TA
authors.lastname: Turvey
mesh_terms: D000293:Adolescent; D003389:Cranial Nerve Diseases / Q000175:diagnosis* / Q000601:surgery*; D003937:Diagnosis, Differential; D005094:Exophthalmos; D005260:Female; D006801:Humans; D006987:Hypesthesia; D008297:Male; D009886:Ophthalmoplegia; D009916:Orbital Diseases / Q000175:diagnosis* / Q000601:surgery*; D019340:Osteotomy, Le Fort; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D014786:Vision Disorders
keywords: cavernous sinus syndrome; maxillofacial surgery; ophthalmoplegia; optic neuropathy; orbital apex syndrome; orbital compartment syndrome; proptosis; ptosis; superior orbital fissure syndrome