Journal of Clinical Otolaryngology Head and Neck Surgery (임상이비인후과)

The Busan, Ulsan, Gyeoungnam Branch of Korean Society of Otolaryngology-Head and Neck Surgery (대한이비인후과학회 부산,울산,경남 지부회)
권호 표지

Pediatric Orbital Blowout Fracture : A Retrospective Study of 116 Patients

소아 안와골절 환자의 임상적 고찰

  • Kim, Jung Suk (Department of Otorhinolaryngology-Head and Neck Surgery, Maryknoll Medical Center) ;
  • Bae, Gyo Han (Department of Otorhinolaryngology-Head and Neck Surgery, Maryknoll Medical Center) ;
  • Park, Tai Jung (Department of Otorhinolaryngology-Head and Neck Surgery, Maryknoll Medical Center) ;
  • Jung, Tae Young (Department of Otorhinolaryngology-Head and Neck Surgery, Maryknoll Medical Center)
  • 김정석 (메리놀병원 이비인후과) ;
  • 배교한 (메리놀병원 이비인후과) ;
  • 박태정 (메리놀병원 이비인후과) ;
  • 정태영 (메리놀병원 이비인후과)
  • Received : 2018.09.19
  • Accepted : 2018.11.15
  • Published : 2018.12.30

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Abstract

Background and Objectives : Pediatric orbital blowout fractures occur in discreet patterns, in reference to the characteristic developmental anatomy of the facial skeleton at the time of injury. The purpose of this study was to investigate the clinical characteristics, ocular symptom, fracture type and postoperative results of orbital blowout fractures in the pediatric population. Material and Methods : A retrospective study was conducted from January 2009 to June 2015 in 116 patients with orbital floor fractures ; all less than 18 years old. Patients were divided into 3 groups by age : 0 to 6, 7 to 12, and 13 to 18 years of age. The cause of fracture, fracture site and type, preoperative and postoperative ocular symptoms, timing of surgery were reviewed from their records. Results : Medial wall fractures were the most common site in the 0 to 6 years old group, and floor fractures were the most common site in other age groups. However, floor fracture was the most common site of the need for surgery in all age groups. Trapdoor type of fractures occurred more frequently than open door type of fractures in all age groups. Preoperative symptoms did not differ among the 3 age groups. In case of need surgery, frequency of preoperative ocular symptoms increased with age. However, as age group was young, rate of residual postoperative ocular symptoms were increased. Conclusions : The younger patients are more to have trapdoor type fracture and residual postoperative ocular symptom. Earlier surgical intervention more needed for children with entrapment results.

Keywords

References

  1. Bansagi ZC, Meyer DR. Internal orbital fractures in the pediatric age group: characterization and management. Ophthalmology 2000;107:829-36. https://doi.org/10.1016/S0161-6420(00)00015-4
  2. Yang HW, Bae JH, Lee HC. The postoperative recovery of ocular motility in pediatric Blow-out fracture. J Korean Ophthalmol Soc 2003;44:259-64.
  3. Lee SJ, Park GS. Relationship between preoperative clinical features and postoperative recovery of ocular motility restriction in Blow-out fracture. J Korean Ophthalmol Soc 2001;42:1202-9.
  4. Wachler BS, Holds JB. The missing muscle syndrome in blowout fractures: an indication for urgent surgery. Ophthal Plast Reconstr Surg 1998;14:17-8. https://doi.org/10.1097/00002341-199801000-00005
  5. Egbert JE, May K, Kersten RC, Kulwin DR. Pediatric orbital floor fracture: direct extraocular muscle involvement. Ophthalmology 2000;107:1875-9. https://doi.org/10.1016/S0161-6420(00)00334-1
  6. Jordan DR, Allen LH, White J, Harvey J, Pashby R, Esmaeli B. Intervention within days for some orbital floor fractures: the white-eyed blowout. Ophthal Plast Reconstr Surg 1998;14(6):379-90. https://doi.org/10.1097/00002341-199811000-00001
  7. Tong L, Bauer RJ, Buchman SR. A current 10-year retrospective survey of 199 surgically treated orbital floor fractures in a nonurban tertiary care center. Plast Reconstr Surg 2001;108:612-21. https://doi.org/10.1097/00006534-200109010-00003
  8. Hwang K, You SH, Sohn IA. Analysis of orbital bone fractures: a 12-year study of 391 patients. J Craniofac Surg 2009;20:1218-23. https://doi.org/10.1097/SCS.0b013e3181acde01
  9. Alcala-Galiano A, Arribas-Garcia IJ, Martin-Perez MA, Romance A, Montalvo-Moreno JJ, Juncos JM. Pediatric facial fractures: children are not just small adults. RadioGraphics 2008;28:441-61. https://doi.org/10.1148/rg.282075060
  10. Yoon KC, Seo MS, Park YG. Orbital trapdoor fracture in Children. J Korean Med Sci 2003;18:881-5. https://doi.org/10.3346/jkms.2003.18.6.881
  11. Kwon YH, Park DW, Chung JY, Ahn HB. A clinical study of pediatric orbital wall fracture. J Korean Ophthalmol Soc 2006;47:7-12.
  12. Park JH, Kim DH. Prognosis and Clinical Features of Orbital Wall Fracture in Preschool Children. J Korean Med Soc 2011;52(12):1490-1495.
  13. De Man K, Wijngaarde R, Hes J, De Jong PT. Influence of age on the management of blow-out fractures of the orbital floor. Int J Oral Maxillofac Surg 1991;20:330-6. https://doi.org/10.1016/S0901-5027(05)80260-7
  14. Anderson PJ, Poole MD. Orbital floor fracture in young children. J Craniomaxillofac Surg 1995;23:151-4. https://doi.org/10.1016/S1010-5182(05)80003-4
  15. Koltai PJ, Amjad I, Meyer DR, Feustel PJ. Orbital fracture in children. Arch Otolaryngol Head Neck Surg 1995;121:1375-9. https://doi.org/10.1001/archotol.1995.01890120033006
  16. Matteini C, Renzi G, Becelli R, Belli E, Iannetti G. Surgical timing in orbital fracture treatment: experience with 108 consecutive cases. J Craniofac Surg 2004;15(1):145-50. https://doi.org/10.1097/00001665-200401000-00035