Isfahan Eye Research Center, Department of Ophthalmology, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Ophthalmology, Poostchi ophthalmology research center, school of medicine, Shiraz University of Medical Sciences, Shiraz, Iran.
Oral Maxillofac Surg. 2024 Nov 6;29(1):7. doi: 10.1007/s10006-024-01302-6.
To evaluate clinical presentations, computed tomography (CT) findings, and various prognostic factors affecting the surgical outcomes of trapdoor fractures.
This retrospective multi-center study reviewed medical records and orbital CT scans of patients under 21 years old, diagnosed with isolated trapdoor fractures. The study was conducted across multiple medical centers, including emergency and clinical departments in Isfahan, Shiraz, and Tehran-Iran. The characteristics and outcomes following surgical intervention were assessed.
45 patients with isolated trapdoor fractures were included in the study, with a mean age of 11.67 ± 4.69 years, predominantly male (84.4%). Vehicle accidents was the major cause of fractures (31.1%). 44 patients (97.8%) had orbital floor fracture, and one patient (2.2%) had medial wall involvement. Nausea/vomiting were reported in 41 patients (91.1%). Surgical intervention within 2 days, resulted in 85.0% of patients experiencing no postoperative diplopia. Delayed surgery beyond 2 days showed increased odds of diplopia, although not statistically significant. CT scan findings suggested a lower risk of diplopia in patients with soft tissue entrapment compared to muscle involvement (OR: 0.336, 95% CI: 0.077-1.462, p = 0.146). Shorter time to surgery (within 2 days) was significantly associated with normal postoperative eye movements (p = 0.002). Nausea/vomiting were more prevalent in patients with muscle entrapment (p < 0.05).
Surgical intervention within 48 h is crucial for improving ocular motility following trapdoor fractures. Extraocular symptoms, including nausea/vomiting, should raise suspicion for trapdoor fractures in cases of orbital trauma associated with ocular movement impairment.
Not applicable.
评估影响颅颊窝骨折手术结果的临床表现、计算机断层扫描（CT）表现和各种预后因素。
本回顾性多中心研究回顾了伊朗伊斯法罕、设拉子和德黑兰多个医疗中心的急诊和临床科室诊断为孤立性颅颊窝骨折的 21 岁以下患者的病历和眼眶 CT 扫描。评估了手术干预后的特征和结果。
本研究纳入了 45 例孤立性颅颊窝骨折患者，平均年龄为 11.67±4.69 岁，主要为男性（84.4%）。车辆事故是骨折的主要原因（31.1%）。44 例患者（97.8%）有眶底骨折，1 例患者（2.2%）有内侧壁受累。41 例患者（91.1%）有恶心/呕吐。2 天内进行手术干预的患者中，85.0%的患者术后无复视。超过 2 天进行手术的患者发生复视的几率增加，但无统计学意义。CT 扫描结果表明，与肌肉受累相比，软组织嵌顿的患者发生复视的风险较低（OR：0.336，95%CI：0.077-1.462，p=0.146）。手术时间较短（2 天内）与术后眼运动正常显著相关（p=0.002）。肌肉嵌顿的患者更常见恶心/呕吐（p<0.05）。
颅颊窝骨折后 48 小时内进行手术干预对于改善眼球运动至关重要。在与眼球运动障碍相关的眼眶创伤病例中，如果存在眼外症状，包括恶心/呕吐，应怀疑颅颊窝骨折。
不适用。
