[Traumatic superior orbital fissure syndrome: Update].
The traumatic superior orbital fissure syndrome is an uncommon complication of craniomaxillofacial trauma. The diagnosis is clinical and associates ophtalmoplegia (constantly at initial clinical examination), ptosis and anaesthesia of the forehead. Young men victim of road traffic accidents are most often affected. CT-scan usually shows facial and/or craniofacial fractures more or less spreading towards the superior orbital fissure. The absence of fracture seen at the X-rays does not eliminate the diagnosis. Initial management should be multidisciplinary (maxillofacial surgeons, ophthalmologists and neurosurgeons) and conducted early if possible. It combines high-dose corticosteroids and decompression surgery if necessary. Abstention may be indicated in cases of delayed diagnosis with spontaneous improvement. Symptoms improve early but follow-up should be extended over several months given the recovery time.
Service de stomatologie, chirurgie maxillofaciale, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire, boulevard de Lattre-de-Tassigny, 21079 Dijon, France; Faculté de médecine, université de Bourgogne, boulevard Jeanne-d'Arc, 21079 Dijon, France. Electronic address: marine.girodon@gmail.com.
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Girodon
Service de stomatologie, chirurgie maxillofaciale, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire, boulevard de Lattre-de-Tassigny, 21079 Dijon, France; Faculté de médecine, université de Bourgogne, boulevard Jeanne-d'Arc, 21079 Dijon, France.
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Levasseur
Service de stomatologie, chirurgie maxillofaciale, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire, boulevard de Lattre-de-Tassigny, 21079 Dijon, France; Faculté de médecine, université de Bourgogne, boulevard Jeanne-d'Arc, 21079 Dijon, France.
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Wajszczak
Service de stomatologie, chirurgie maxillofaciale, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire, boulevard de Lattre-de-Tassigny, 21079 Dijon, France; Faculté de médecine, université de Bourgogne, boulevard Jeanne-d'Arc, 21079 Dijon, France.
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Ernoult
Service de stomatologie, chirurgie maxillofaciale, chirurgie plastique, esthétique et reconstructrice, chirurgie de la main, centre hospitalier universitaire, boulevard de Lattre-de-Tassigny, 21079 Dijon, France; Faculté de médecine, université de Bourgogne, boulevard Jeanne-d'Arc, 21079 Dijon, France.
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Zwetyenga
D019299:Decompression, Surgical / Q000379:methods; D006801:Humans; D008446:Maxillofacial Injuries / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D009915:Orbit / Q000293:injuries* / Q000601:surgery; D009917:Orbital Fractures / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D013577:Syndrome
Diplopia; Diplopie; Fissure orbitaire; Orbital fissure; Os sphénoïde; Sphenoid bone