Orbital Defects Research Articles

Ultrasound Findings of Fetal Infections: Current Knowledge

Infectious diseases during pregnancy are still a major cause of fetal mortality and morbidity worldwide. The most common teratogenic pathogens are cytomegalovirus (CMV), varicella-zoster virus (VZV), rubeovirus, parvovirus B19, herpes simplex virus (HSV), Toxoplasma gondii, Treponema pallidum and the emergent Zika virus (ZIKV). Ultrasound findings include cerebral anomalies, orbital defects, micrognathia, cardiac defects, hepatosplenomegaly, liver calcifications, abdominal anomalies, skin and limb anomalies, edema, placental and amniotic fluid anomalies and altered Doppler analyses. The classification of ultrasound markers of congenital infections by anatomical region is reported to guide differential diagnosis and prenatal care.

P-67915014-268 - Does intra-operative navigation improve accuracy of implant position in secondary reconstruction of large orbital defects?

<h3>Background and Purpose</h3> Literature supporting use of intra-operative navigation (ION) in orbital reconstruction is abundant. However, evidence on the role of ION in improving orbital implant position is sparse. Our objective was to determine if ION influenced implant position accuracy in secondary orbital reconstruction. <h3>Methods</h3> This was designed as a prospective observational study comparing two groups of patients requiring secondary orbital reconstruction; the test group received intra-operative guidance with ION, while the control did not. The groups were matched for age and defect size. Primary outcome variables included assessment of deviations between the ideal implant position and achieved implant position in six degrees of freedom; horizontal, vertical and transverse (linear), pitch, roll and yaw (angular). Secondary outcome variables included assessment of procedural time. Descriptive and inferential statistics were used to compare means and variance. <h3>Results</h3> A total of 24 patients were recruited into the study with a mean age of 27.79 years. Results demonstrated that implant position accuracy was significantly superior in the transverse plane (medio-lateral) for the test group (p=0.03). The total duration of the procedure was longer by 8minutes (p=0.047), while surgery time was 15minutes shorter when using ION (p<0.001). This was due to the additional equipment setup time for the test group (mean 23mins, p<0.001). <h3>Conclusion</h3> The study demonstrated that ION may be a useful intra-operative guide to improve implant position in infero-medial orbital defects requiring reconstruction. ION also reduced the time required for intra-orbital dissection and positioning of the implant.

Prosthetic rehabilitation of acquired orbital defect along with complete rehabilitation of edentulous mouth

Loss of eye, apart from impaired vision has a detrimental effect on the psychosocial wellbeing of an individual. The replacement of the lost eye as soon as possible after the surgery is necessary to improve social acceptance and quality of life. Multidisciplinary management and team approach between surgeon and prosthodontist are essential in providing accurate and effective rehabilitation and follow-up care for the patient. Although various treatment modalities are available it may not be advisable for all the patients due to some medical conditions or economic factors. The present article describes a simplified technique for the fabrication of a Room Temperature Vulcanized (RTV) silicone orbital prosthesis to achieve optimal fit and esthetics.

Polypropylene mesh and conchal cartilage composite graft: a novel technique for orbital floor reconstruction

&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Fractures of the orbital floor can occur as a part of maxillofacial trauma and be associated with prolapse of orbital contents into maxillary sinus. It may be associated with entrapment signs mandating surgical repair of the orbital floor. Aim of the study was to study the role of a composite graft in the repair of orbital floor fractures in a tertiary care center.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Retrospective chart review of 16 patients who underwent orbital floor repair in a tertiary care center was undertaken. All patients underwent surgical repair with a composite graft made of cartilage and polypropylene mesh by subciliary approach.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Post-operatively, none of the patients had restriction of mobility, diplopia, or globe asymmetry. Mild entropion was noted in two patients but did not require any intervention. No extrusion of the implant was seen.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Conchal cartilage and polypropelene mesh composite graft is a reliable and easily available material for the repair of orbital floor defects in almost all kinds of orbital floor fractures.&lt;/p&gt;

The anatomic classification of the anophthalmic eye socket (Types 0–V): A high-level taxonomy classification system

Eyelid and orbital deformities caused by various defects, such as tumor resection and trauma, whether congenital or acquired, are extremely complex and atypical. Several classifications systems for these anophthalmic conditions have been developed, but none have proven suitable for determining the ideal reconstructive surgical strategy. We therefore designed a novel system known as the Anatomic Classification of the Anophthalmic Eye Socket (Types 0-V) for optimum reconstruction of anophthalmic socket deformities focusing on eyelid and orbital defects. Type 0 is an eyelid defect type, in which only the eyelid is defective; Type I is a phthisis bulbi type, in which the anatomical eyeball is preserved, but the visual function is lost; Type II is a substitution type involving filling with implant packing after evisceration or enucleation; Type III is an enucleation type involving enucleation of the ophthalmus; Type IV is an exenteration (incomplete) type involving exenteration while saving the eyelids; and Type V is an exenteration (complete) type involving exenteration including eyelid defects. Using this classification system, it will be possible to standardize reconstructive procedures of the anophthalmic socket.

Successful Management of Post-Traumatic Residual Orbital Roof Defects with Cosmetic Disfigurement and Functional Deficits Using Innovative Titanium Plate Orbitoplasty.

Late presentations of post-traumatic residual orbital roof deformities ensuing from old, unaddressed orbital injuries, can be extremely challenging to manage and quite complicated to correct, owing to proximity of the brain and frontal sinus, malunion or bony fusion of the displaced, delicate orbital fracture fragments, necrosis of entrapped extraocular muscles and progressive intraorbital soft tissue fibrosis and adhesions. There exists a paucity in literature on delayed repair of displaced and comminuted orbital roof fractures and late reconstruction of the three-dimensional architecture of the orbital frame and internal orbit. To present an unusual case of severe post-traumatic residual orbital roof deformity, resulting in longstanding aesthetic disfigurement and persisting functional deficits, and its successful management. The patient had sustained orbital injuries sixteen months ago, on being punched in the face at a boxing tournament. The increased orbital volume produced by an impure blowout fracture of the left orbital roof, with comminution of the upper and lower orbital rims, had resulted in considerable cosmetic deformity, discomfort as well as functional debility, all of which were successfully and efficaciously managed by an innovative use of a Titanium Orbital Plate for orbital roof reconstruction. Overlooked, undetected or ignored derangements in intraorbital volume and contour, can lead to severe cosmetic disfigurement in the form of enophthalmos, hypoglobus, entropion, telecanthus, palpebral fissure width narrowing and ptosis; in addition to crippling functional deficits, such as diplopia, blurred vision, levator dysfunction, restricted ocular motility and reduced visual range and acuity. An innovative Titanium mesh orbitoplasty enabled achievement of both, the aesthetic and functional goals of reconstruction of the distorted bony orbit, with successful correction of severe functional and aesthetic deficits.

Modern capabilities of the computed tomography in orbital traumatic injuries diagnosis

BACKGROUND: Nowadays the problem of orbital trauma remains extremely relevant. Combined damage of several anatomical structures, globe injury, various clinical manifestations, the necessity of optimal surgical treatment require high-quality, timely diagnostics. Considering the current development of diagnostic equipment, postprocessing of CT data acquires the key role in order to obtain objective diagnostic information in patients with orbital trauma.&#x0D; AIM: Evaluation of the effectiveness of the developed methods for CT data assessing in patients with orbital trauma.&#x0D; MATERIALS AND METHODS: From 2016 to 2021 a total of 107 patients (100%) with orbital injuries were examined in Sechenov University clinics. All patients were distributed depending on the injury occurrence time: 50 patients (47%) in acute and subacute periods, 30 patients (28%) in the period of formation of post-traumatic deformities, 27 patients (25%) in the period of formed post-traumatic deformities. All patients (n = 107; 100%) underwent CT data analysis according to the developed protocol: analysis of bone and soft tissue trauma using a specialized algorithm, assessment of orbital volumes, evaluation of defects in the inferior orbital wall, examination of the globe position and of changes in the density of the orbital soft tissues.&#x0D; RESULTS: In the preoperative period the developed algorithm for orbital volumes measuring additionally revealed a post-traumatic increase in orbital volume in 21 patients (19%). The technique for the globe position assessing additionally revealed the risk of enophthalmos in 9 patients (8.1%), and in 1 case (0.9%) the suspicion of globe displacement was not confirmed. The defects of the inferior orbital wall were classified into small (n = 18; 17%), medium (n = 31; 29%) and large/total (n = 38; 35% and n = 20; 19%, respectively). In 88 patients (82%), the ratio of the defect to the entire inferior orbital wall was more than 6.65%, in 19 patients (18%) less than 6.65%. Changes in the density of the orbital soft tissues were as follows: soft tissue edema n = 60 (56%), soft tissue atrophy n = 28 (27%), hematoma of the orbital soft tissues n = 10 (9%), density was not changed n = 9 (8%). In the postoperative period, the developed methods for CT data processing revealed incomplete restoration of the orbital volume in 31 cases (29%), incomplete coverage of the inferior orbital wall defect in 38 cases (35%), globe displacement in 14 cases (13%), which was not determined by the standard CT data assessment without the specialized technique. In 7 cases (6%), a suspicion of an increase in the orbital volume was not confirmed by the developed methodology.&#x0D; CONCLUSION: The developed methods for measuring orbit volumes, assessing defects in the lower orbital wall, the globe position, and the condition of the orbital soft tissues provide statistically reliable additional diagnostic information about the patients condition and personalized approach for preoperative planning for each patient.

Assessing the feasibility of using autogenous maxillary bone graft to repair isolated orbital floor fractures: A pilot study using CT measurements

AbstractIntroductionOrbital floor fractures are a common injury managed by oral maxillofacial surgeons. They can result in significant bony defects that increase the orbital volume and necessitate surgical repair to avoid the development of enophthalmos. A variety of materials have been used in the reconstruction of orbits including alloplastic materials and autogenous bone grafts. The use of the anterior maxillary antral wall as a bone graft offers the advantage of being readily accessible, naturally thin and has less donor site morbidity than other bone graft sites. There is a paucity of literature in regards to how and when to use an anterior maxillary antral wall graft.Materials and MethodsWe performed a retrospective review of computerized tomography head scans for patients presenting with isolated orbital floor fractures over a 5‐year period. 25 patients were included in the study and manual measurements were recorded for the orbital floor defect and the dimensions of the ipsilateral and contralateral anterior maxillary wall.ResultsIt was found that 92% of fractures could have been repaired using a contralateral anterior maxillary wall bone graft (p &lt; 0.05).ConclusionUse of the anterior wall of the maxillary antrum is a feasible alternative to traditional alloplastic materials. Further study using three‐dimensional bio‐modelling could help developing more accurate guidelines for using this technique in orbital fracture repair.

Is Surgery Needed for Diplopia after Blowout Fractures? A Clarified Algorithm to Assist Decision-making.

Background:Diplopia is a common symptom after blowout fractures, with an incidence of 43.6%–83%. Although there is some consensus toward surgical correction, diplopia is not always resolved by surgery. Thus, there is a clinical dilemma for surgeons with regard to performing surgery at a specific time. This review aimed to create an algorithm to support accurate and effective decision-making.Methods:We reviewed articles published on PubMed during 2013–2020 regarding orbital fractures. Articles discussing surgical treatment for blowout fractures and diplopia were included. Five reviews, six prospective cohort studies, and 33 retrospective studies were identified. After reviewing and summarizing these articles, a step-by-step algorithm was created.Results:Most authors advise immediate surgery when a patient presents with either a positive oculocardiac reflex or a “trapdoor” fracture. Early surgical correction is recommended in children to prevent profound muscle damage. In other scenarios, most authors recommend performing surgery within 2 weeks. The algorithm begins with the aspect of motility, including muscle entrapment assessed by computed tomography or limited movement of the extraocular muscle. When there is no abnormality in motility, the algorithm continues to the aspect of position. Generally, an orbital floor defect of more than 50% or 2 cm2 or an enophthalmos of more than 2 mm is indicated for surgery. However, diplopia may also gradually resolve after improvement of periorbital edema or swelling.Conclusion:We proposed a step-by-step approach to help surgeons make effective decisions concerning surgical correction for patients suffering from blowout fractures with diplopia at different time points.

Correction of Post-Traumatic Enophthalmos by Orbital Floor Reconstruction with Titanium Mesh

Aim: To see the efficacy of titanium mesh in orbital floor reconstruction to correct the post-traumatic enophthalmos in orbito-zygomatic complex fractures. Methods: This retrospective study was carried out in the department of Oral and Maxillofacial Surgery, University College of Medicine &amp; Dentistry, University of Lahore, Pakistan from January 2017 to January 2020. All patients who had enophthalmos after orbito-zygomatic fractures and were treated for orbital floor reconstruction with titanium mesh were included in the study. Computer tomography (CT scan) was done to diagnose and measure the orbital floor defect. Pre-operative and post-operative hertalex ophthalmometry was done to measure and compare the enophthalmos. Results: Among the 30 patients, 23 were male and 7 were female. The mean age of the patients was 30±5.80 years. Fourteen patients had right and 16 patients had left side orbitozygomatic complex fracture. The mean orbital floor defect size was 1.72±0.78 cm preoperatively measured by CT scan. There was a correction of enophthalmos in 23 patients out of 30(76.66%). Conclusion: Titanium mesh is a commonly used and easily available material for the correction of orbital floor defects. It is efficacious in terms of the correction of post-traumatic enophthalmos resulting from orbito-zygomatic complex fracture. Keywords: Enophthalmos, titanium mesh, orbitozygomatic fractures

Navigational Transmaxillary Endoscopic Approach for Inferomedial Tumors.

Orbital tumors encompass a heterogeneous range of histopathology and usually variable in location. Traditionally, transconjunctival medial orbitotomy is used to access the medial orbital wall. However, it creates potential risk of soft tissue sequelae such as scarring, lid contracture, or entropion/ectropion. For the lesions close to the orbital apex, increased risk of optical nerve injury should be cautious during orbitotomy procedure. Transnasal endoscopic approach to the orbital walls has been applied since 1999. Although it provides good surgical visualization and prevents the soft tissue and neural complications, the narrow nasal corridor increases the surgical complexity. Extensive sphenoethmoidectomy is usually required to gaining access. Furthermore, the resultant medical orbital defect is difficult to repair. The maxillary sinus is the largest paranasal sinuses which is located beneath the orbital floor. It provides an ample working space for instrumentation. Meanwhile, repair of the orbital floor defect is feasible and with high degree of accuracy under navigation control. In this report, we propose a novel computer-assisted endoscopic protocol to excise the medial orbital tumors with immediate repair of the wall defect.

Title of the manuscript: Interim rehabilitation of a patient with orbital defect by a customized ocular prosthesis -A case report.

Title of the manuscript: Interim rehabilitation of a patient with orbital defect by a customized ocular prosthesis -A case report.

A challenging journey of maxillofacial implants placement and rehabilitation in an irradiated exenterated socket

Rehabilitation of a post-exenterated orbital defect is a necessity, to restore a patient's esthetic appearance and help overcome the associated psychosocial stigma. An implant supported prosthesis enjoys a better patient acceptance due to its superior retention and stability. This clinical report highlights the challenges faced in planning, designing and placement of maxillofacial implants in the supra-orbital rim of an exenterated socket post-radiotherapy along with the management of the unexpected complications which developed subsequently. Administration of hyperbaric oxygen therapy, fabrication of a digitally designed surgical guide to ensure predictable implant placement, selection of surface treated implants for better biomechanical anchorage, and a gentler surgical technique for recovery of irradiated hard and soft tissues were measures undertaken during the treatment phase. An effort has been made to point-out the fact that despite the various approaches adopted in an irradiated patient, success of implant placement in such a situation remains a challenge.

Rehabilitation of post Covid mucormycosis maxillectomy defect with hollow obturator: A case series

India saw a devastating second wave of Coronavirus and along with the fatal nature of the disease the healthcare professionals saw a huge number of post Covid problems. One of these, is a fungal disease called mucormycosis which although an uncommon fungal infection can cause blackening of skin, redness, inflammation, sores and can encroach the eyes, lungs and even the brain. This warrants for extensive surgical resection and debridement of the necrosed areas resulting in maxillary and orbital defects. Intraoral defects in the maxilla cause communication with the nasopharyngeal complex. The surgically removed palate has a devastating effect on the appearance and speech of the patient. Obturator allows patients to eat and drink without letting the food to enter the oroantral cavities/ pharynx during mastication. This case series focusses on prosthetic rehabilitation of two patients with Hollow obturator post hemimaxillectomy in order to restore form and function.

Treatment of Orbital Floor defects with Titanium Mesh in Zygomatic Complex Fractures

Background: Outcome of treatment of orbital floor defects with titanium mesh in zygomatic complex fractures. Eye trauma results in significant aesthetic and functional problems. Rehabilitation necessitates a grasp of the orbit's altered structure and function, as well as the materials and procedures used in its restoration. Study design: Descriptive case series Study duration: 1 year.22 December 2018 to 21 December 2019. Study place: Allama Iqbal Teaching Hospital, Kh. Muhammad Safdar Medical College, Sialkot Results: This study was carried on 150 patients over a period of 6 months from January 1st 2013 to June 30th 2013 at the department of Oral &amp; Maxillofacial Surgery PIMS Hospital Islamabad. 135/150(82.75%) patients were male and 15/150(17.24%) patients were female. The mean average age of the male patients was 30.02 years + 10.26 and the mean average age of the female patients was 29.90 years + 10.53. In our study 82.8% were males and 17.8 were females. Conclusion: The conclusion of study is titanium mesh isa better treatment option in management of complex orbito-zygomatico complex fractures, Diplopia is initially present but eventually resolve within 3 month. Keywords: Titanium mesh, zygomatic complex fracture

Post exenteration surgery rehabilitation with orbital prosthesis – A case report

Orbital defects with total loss of eyelids and the eyeball cannot be satisfactorily repaired by reconstructive surgery. Therefore, a prosthetic placement is the treatment of choice to return the individual’s confidence by producing an acceptable and lifelike appearance. Male patient, 31 years old, came with history of exenteration surgery four months ago on right eye because of infection few years before. Patient wanted orbital prosthesis to improve esthetic and self-confidence. He lost his right eye ball and some part of right eyelid. Treatment of choice that would be fabricated was orbital prosthesis with medical adhesive retention support. Orbital prosthesis was one of the alternative that can be chose to reconstruct orbital defect. The success of the prosthesis was determined by the exactness of diagnosis, treatment plan determination, material selection, determination of prosthesis retention, and technique in processing the prosthesis.

A Novel Patient-specific Titanium Mesh Implant Design for Reconstruction of Complex Orbital Fracture.

Background:Complex orbital fractures, including orbital rims and walls, require precise reconstruction. A titanium-based patient-specific implant (PSI) benefits over other implants when challenged with narrow surgical space and designable implant fixation point.Methods:This is a prospective noncomparative case series to evaluate the effect of complex orbital reconstruction using the newly designed lateral fixation patient-specific implant. The PSI was individually fabricated by 3D reconstruction using the mirrored nonaffected orbit as a template. The fixation point was at maxillary or zygomatic bone, depending on the bony remnant. Outcomes were obtained from computed tomography scan to compare orbital tissue volume and exophthalmometry value by posterior clinoid method before and after the surgery and also between both orbits in each patient.Results:Sixteen patients with complex orbital fracture with inferior orbital rim defect were enrolled. Seven were previously repaired with other implants. Compared with the preoperative measurement, the postoperative mean difference of orbital volume and exophthalmometry value between both eyes was significantly decreased (reduction of the mean difference of 2904.40 mm3; P < 0.001 and 2.89 mm; P < 0.001, respectively). The mean orbital volume and exophthalmometry value between affected and unaffected eyes were not different after surgical correction (P = 0.57 and P = 0.28, respectively). There was one infected wound from retained foreign body and one unresolved vertical diplopia after the reconstruction.Conclusions:Reconstruction of complex orbital fractures using the novel designed-PSI had excellent outcomes. Appropriate implant design with caution of orbital anatomy and placement techniques are keys for successful results.

Accuracy of globe-sparing orbital reconstruction using individually bent titanium mesh: A comparative study

Accurate reconstruction of orbital and midfacial defects following extensive globe-sparing maxillectomy is challenging, due to the complex anatomy of facial skeleton. The aim of this study is to evaluate the outcomes of individually bent titanium mesh in navigation-assisted reconstruction of post-ablative orbits in comparison with that without intraoperative navigation. Forty-one patients undergone globe-sparing maxillectomy and orbital floor reconstruction using individually bent titanium mesh with or without intraoperative navigation were assessed. Pre- and postoperative orbital projection and volume measurements were performed on both orbits. The unaffected orbit was used as a control for comparison. True-to-original orbital reconstruction was achieved in this study. The average difference of globe projection and orbital volume between unaffected and reconstructed orbits was 0.8±0.5mm and 0.9±1.2cm3, respectively, in navigation-assisted group. In non-navigation-assisted group, the average difference of globe projection and orbital volume of unaffected and reconstructed orbit was 0.7±0.5mm and 1.3±1.3cm3, respectively. There was no statistical significance in mean differences between unaffected and affected globe projection (P=0.744) and orbital volume (P=0.677) in both groups. There was also no significant difference observed when comparing the mean differences between pre- and postoperative globe projection (P=0.659) and orbital volume (P=0.582) in both groups. While intraoperative navigation system was shown to be effective in orbital reconstruction in the past decade, equal satisfactory post-ablative orbital reconstruction can be achieved with individually bent titanium mesh with or without intraoperative navigation.

Reconstruction of orbital exenteration defects: about 20 cases

The face is social support. Eyes allow the individual to interact with the environment and others. Orbital exenteration defects are the results of extreme disfiguring surgery, leading to functional, aesthetic and psychological sequelae. Reconstruction is essential and must meet several objectives: filling the cavity and closing any communications with the adjacent structures, obtaining rapid healing, allowing for local monitoring and finally enabling patients to reintegrate into society and achieve a satisfactory quality of life. We here present our experience in filling and reconstructing these cavities. Our study involved 20 patients with orbital exenteration defects over a period of 5 years (February 2015-February 2020). We analyzed the epidemiological features, clinical profile, and methods of the reconstruction as well as patients´ outcomes in our hospital. The average age of patients was 58.5 years. Squamous cell carcinoma was the main histological type, followed by basal cell carcinoma. Filling techniques included directed wound healing (7 cases), temporalis fascia flap (2 cases), temporalis muscle flap (10 cases). Methods of reconstruction included directed wound healing (6 cases), full-thickness skin graft (1 case), mediofrontal flap (6 cases; alone or associated with the temporalis muscle), converse scalping flap in three cases. Free latissimus dorsi flap was used in two cases. Thirteen patients showed good outcomes, with good healing after an average follow-up period of 9 months. The most common complication was infection and suture release. Two patients were lost to follow-up. Orbital exenteration defects can be approached in many ways. Temporalis muscle flap has been shown to be a robust and safe choice as well as an excellent filling solution. Prostheses are an aesthetic but expensive solution that should be developed in our hospital.

Orbital magnetic resonance imaging profile and clinicoradiological correlation in COVID-19-associated rhino-orbital-cerebral mucormycosis: A single-center study of 270 patients from North India

Purpose:To study the clinical profile and magnetic resonance imaging (MRI) features in patients of COVID-19-associated rhino-orbital-cerebral mucormycosis (CA-ROCM) with orbital involvement and perform a clinicoradiological correlation.Methods:A cross-sectional study was performed at a tertiary care center in north India from May 2021 to June 2021. Consecutive patients with clinical, nasal endoscopic, and/or microbiological evidence of CA-ROCM underwent MRI of paranasal sinuses, orbit, and brain as per the study protocol. Orbital MRI findings were studied in detail and were correlated with clinical signs.Results:Two hundred and seventy patients were studied. The mean age was 48.4 (± 16.82) years. A male predilection was noted (male:female = 1.77). Orbital involvement was seen in 146 (54%) patients on clinical evaluation and in 184 (68%) patients on MRI. Unilateral orbital involvement was more common (134; 92%). The most common presenting symptom was periorbital and/or facial pain (141; 52.2%) and the most common clinical sign was periorbital edema (116; 43%). The most common MRI finding was suggestive of orbital cellulitis (160; 59%). Orbital compartment syndrome was found in 17 (6.3%) patients. The inter-rater agreement between clinical and radiological assessments to detect the involvement of infraorbital nerve and frontal nerve was found to be 85.56%, (κ 0.621) and 93.70% (κ 0.776), respectively. The diagnostic accuracy, sensitivity, and specificity of MRI to detect medial orbital wall defect were found to be 87.9%, 65%, and 97%, respectively.Conclusion:Orbital imaging features of a cohort of ROCM patients have been presented with clinicoradiological correlation.