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. 2023 Jul;133(7):1624-1629.
doi: 10.1002/lary.30477. Epub 2022 Nov 3.

Characteristics of Orbital Injuries Associated with Maxillofacial Trauma

James F Eng  1 , Sami Younes  2 , Brielle R Crovetti  2 , Katherine J Williams  3 , Angela D Haskins  1 , David J Hernandez  1 , Michael T Yen  3 , Krista L Olson  1 , Richard C Allen  3 , Sunthosh K Sivam  1
Affiliations

Characteristics of Orbital Injuries Associated with Maxillofacial Trauma

James F Eng et al. Laryngoscope. 2023 Jul.

Abstract

Introduction: The incidence of ocular injury associated with maxillofacial trauma remains poorly defined, with reported rates ranging from 0.8% to 92%. Our study aims to more accurately characterize ocular injuries associated with midface fractures.

Methods: We performed a retrospective review of 1677 patients from 2015 to 2020 with midface fractures at a Level I trauma center. Isolated nasal bone and frontal process of the maxilla fractures were excluded. Demographic information, mechanism of injury, need for surgery, and ophthalmologic findings were documented. Statistical analysis was conducted using SPSS.

Results: 773 patients between the ages of 15 and 92 were identified. Trauma most commonly resulted from assault (63.8%). The association between the mechanism of injury and ocular injury was statistically significant (p = 0.003), with 78.6% of gunshot wounds and 44.3% of assault patients having an ocular injury. The Ophthalmology service evaluated 62.6% of cases preoperatively. Minor ocular injury occurred in 36% of patients, including 46.1% of isolated orbital floor, and 28.2% of zygomaticomaxillary complex fractures. Major ocular injury occurred in 10.5% of patients.

Conclusions: Over 10% of patients with midface fractures were found to have major ocular injuries. Ophthalmologic exams should be performed for all patients with midface fractures to guide clinical decision making and prevent further intraoperative ocular insults.

Level of evidence: Level 4. This study represents a retrospective cohort study analyzing ocular injuries detected in patients presenting to a Level I trauma center with maxillofacial fractures between 2015 and 2020 Laryngoscope, 133:1624-1629, 2023.

Keywords: maxillofacial trauma; ocular injury; orbital fractures; zygomaticomaxillary complex fractures.

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References

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