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Isolated traumatic orbital floor fracture: An analysis of the National Trauma Data Bank

世界耳鼻咽喉头颈外科杂志英文版 2024年第3期10卷 187-192页

作者： De Ravin Emma Xu Katherine Fritz Christian S. Parhar Harman Rajasekaran Karthik Department of Otorhinolaryngology Head and Neck Surgery University of Pennsylvania Philadelphia Pennsylvania USA Perelman School of Medicine at the University of Pennsylvania Philadelphia Pennsylvania USA Leonard Davis Institute of Health Economics University of Pennsylvania Philadelphia Pennsylvania USA

Objectives: To date, no study provides a comprehensive analysis of traumatic orbital floor fractures across the United States. We aimed to characterize patient demographics, injury-related variables, and operative management in this ***: The National Trauma Data Bank was queried for open or closed orbital floor fractures from 2008 to 2016. Clinical data were ***: Overall, 148,592 orbital floor fractures were identified, with 142,577 (95.9%) closed- and 6158 (4.1%) open-type fractures. A total of 106,243 (71.5%) patients were male and the median patient age was 41 years. The majority of patients (79.2%) had abbreviated injury scale scores of ≤2, indicating minor/moderate injury. fracture mechanism of injury (MOI) differed by gender, with the most frequent being unarmed fights in men (34.3%) and falls in women (14.0%). There were 29,600 patients (19.9%) with isolated orbital floor (I-OF) fractures. The MOI most strongly associated with operative intervention of with I-OF fractures were penetrating injuries caused by a firearm (odds ratio [OR]: 2.91; 95%confidence interval [CI]: 1.62–5.20) and cuttings/piercings (OR: 2.17; 95%CI: 1.29–3.65).Conclusion: This large epidemiological study reveals that orbital floor fractures tend to present with minor or moderate injuries and are more likely to require operative intervention in setting of firearm or cut/pierce injuries.

关键词： epidemiology National Trauma Data Bank orbital fracture risk factors trauma

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Facial and Periorbital Emphysemas Following a Violent Sneezing: An Atypical Clinical Situation

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International Journal of Otolaryngology and Head & Neck Surgery 2022年第3期11卷 136-142页

作者： Adèle-Rose Ngo Nyeki Caroline Mvilongo Esthelle Minka Ngom Valentin Fokouo Roger Meva’a Léonel Atanga Yannick Mossus Claudine Nkidiaka Luc Meka Abakar Taimou Serge Abogo David Mindja Olive Ngaba Godefroy Koki Francois Djomou Richard Njock ENT Ophthalmology and Stomatology Department Faculty of Medicine and Biomedical Sciences University of Yaoundé I Yaoundé Cameroon Essos Hospital Center Yaoundé Cameroon Central Hospital of Yaoundé Yaoundé Cameroon ENT Department Faculty of Medicine and Pharmaceutical Sciences University of Douala Douala Cameroon Douala General Hospital Douala Cameroon Bertoua Regional Hospital Bertoua Cameroon

Introduction: Facial emphysema is the presence of air in the subcutaneous tissues of the facial region. They can be clinically recognized by the crackling sensation felt when the affected area is palpated. Observation: The authors describe left orbito-facial emphysema that occurred after a violent sneezing episode in a 36-year-old patient. He had significant edema of the left facial and ipsilateral periorbital region associated with major emphysema and complete closure of the left eye. Nasal cavities endoscopy revealed inflammation of the distal orifice of the nasolacrimal duct. The clinical ophthalmologic examination performed in emergency showed left chemosis, slight ocular hypertonia of mechanical origin, and a slight decrease in visual acuity. Pupillary reflexes and retinography were normal. A craniofacial computed tomography (CT) revealed a significant left orbital emphysema, a fracture of the left medial orbital wall (ethmoidal lamina papyracea) with intraconal fat incarceration without entrapment of the medial rectus and significant air infiltration of all the left hemifacial soft tissues. A broad-spectrum antibiotic and anti-inflammatory treatment were instituted, as well as practical advice to prevent a recurrence. We observed progressive resorption of the edema with a return to the normal of the soft tissues and the palpebral cleft in 15 days. Conclusion: These atypical cases can be serious. It is essential to exclude signs of visual deficit and ocular compression. Multidisciplinary management is important.

关键词： Sneezing orbital fracture Emphysema Pneumorbitia

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