Orbital fracture-induced exophthalmos after head injury: a clinical study of 13 cases

Abstract

Objective To study the mechanism, clinical characteristics, diagnosis and treatments of orbital fracture-induced exophthalmos after craniocerebral injury. Methods We retrospectively analyzed the data of 13 patients with orbital fracture-induced exophthalmos after head injury: their causes of injury, clinical situations, types of fracture, operative treatments and surgical outcomes. Spiral CT thin slice scan and three-dimensional reconstruction were performed on the orbit before any treatment, and then, orbital fractures were repaired by corresponding surgical approaches according to the position of fractures and head injury. The effect of operation was evaluated by spiral CT and follow up was performed. Results The patients obviously manifested as having craniocerebral injury and 14 eyeballs in 13 patients had exophthalmos. The average preoperative degree of protrusion was (2.94±0.47) mm.The axial spiral CT together with the reconstructive picture presented the pre- and pro-operative orbital fractures clearly. Orbital fracture positions were situated at superior and medial wall of the orbit. All operations were succeed without death or severe disability. Conclusion The diversify of intracranial pressure is the main reason of orbital fractures which shrinks towards the inter orbit to its volume and induces exophthalmos after craniocerebral injury. The spiral CT examination has vital significance in the diagnosis and treatment of orbital fracture-induced exophthalmos and the patients can obtain good outcome by early surgery. Key words: Head injury; Orbital fractures; Exophthalmos; Spiral CT