| 발표일자: |
2013년 11월 1일(금) ~ 11월 3일(일) |
| 발표번호: |
P(e-poster)-214 |
| 발표장소: |
킨텍스 제2전시장 7B홀 |
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| Management of Paediatric Orbital Fractures |
| Singapore Eye Research Institute(1), Singapore National Eye Centre(2), KK Women’s and Children’s Hospital, Singapore(3)
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| Su Ann Tay(1,2), Lay Leng Seah(1,2,3) |
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Purpose : Children who suffer orbital fractures often present with trapdoor fractures due to the greater elasticity of their orbital bones, and with the potential complications associated, considerations for early surgical intervention have to be made. There have been differing conclusions in studies that describe the management of paediatric orbital fractures, hence, we aim to analyse the features and management of orbital blowout fractures in our local paediatric population.
Methods : This is a retrospective case review that included patients aged </=16 years old who underwent orbital floor fracture repair from 2004- 2011 at our institutions. Clinical data on patients’ demographics, best corrected visual acuity (BCVA), mechanism of injury, exophthalmometry, ocular motility (using the corneal Hirschberg reflex) and radiological features were reviewed.
We defined outcomes as: Excellent when patients were asymptomatic with no observed limitation in ocular motility. Fair when diplopia was present in positions of extreme gaze with mild limitation of ductions (</= 30 degrees) and poor when limitation of ductions > 30 degrees and strabismus in primary position.
Results : Seven patients were recruited. Fifty seven percent (4/7) presented with diplopia, seventy five percent (6/7) had nausea and vomiting, forty two percent (3/7) with infraorbital hypoaesthesia and seven one percent (5/7) with limitation in eye movements. Computed tomography showed orbital blowout fractures involving the floor and/or medial wall with no evidence of muscle entrapment in all patients. The median delay from injury to surgery was 25 days, with fifty seven percent (4/7) having late surgery at more than one week post injury. None of the patients had significant diplopia post-operatively. The median follow up was 6 months. Despite 4 patients undergoing late surgery, they were all sign and symptom free 1 month following surgery.
Conclusion : Good functional outcome can still be achieved even if surgical repair was performed more than one week after injury.
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