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Incarceration of the inferior oblique muscle branch of the oculomotor nerve in patients with orbital floor trapdoor fracture

  • Oculoplastics and Orbit
  • Published:
Graefe's Archive for Clinical and Experimental Ophthalmology Aims and scope Submit manuscript

Abstract

Purpose

To examine the clinical characteristics of patients with concomitant incarceration of the inferior oblique muscle branch of the oculomotor nerve who had suffered from an orbital floor trapdoor fracture with orbital fat incarceration.

Methods

Fifty-nine patients were retrospectively reviewed. Concomitant inferior oblique muscle branch incarceration was diagnosed by inferior oblique muscle underaction on the Hess chart and a missing inferior oblique muscle branch on computed tomographic images on baseline examination.

Results

Eleven patients (18.6%) were diagnosed with concomitant branch incarceration. The patients with branch incarceration were all under 19 years of age, and were younger than those without branch incarceration (P = 0.026). There were no significant differences between the groups in terms of cause of injury, presence of concomitant medial wall fracture, hypoesthesia of the cheek region, or ocular and periocular complications (P > 0.050). All patients with branch incarceration underwent surgical reduction, whereas 16 of 48 patients without branch incarceration were observed without surgery (P = 0.021). Although preoperative binocular single vision field was smaller in patients with branch incarceration (P = 0.026), it improved after surgery, comparable to that of patients without branch incarceration (P = 0.079).

Conclusions

Concomitant incarceration of inferior oblique muscle branch of the oculomotor nerve occurred in 18.6% of patients who had suffered from an orbital floor trapdoor fracture with orbital fat incarceration. Patients with branch incarceration were all under 19 years of age. Branch incarceration resulted in a smaller binocular single vision field, which considerably improved after surgical reduction.

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Funding

No funding was received for this research.

Author information

Authors and Affiliations

  1. Department of Oculoplastic, Orbital, and Lacrimal Surgery, Aichi Medical University Hospital, 1-1 Yazako-Karimata, Nagakute, Aichi, 480-1195, Japan

    Yasuhiro Takahashi, Maria Suzanne Sabundayo & Hirohiko Kakizaki

  2. Department of Plastic and Reconstructive Surgery, Wakayama Medical University, Wakayama, Japan

    Hidetaka Miyazaki

  3. Ide Eye Hospital, Yamagata, Japan

    Hidenori Mito

Authors
  1. Yasuhiro Takahashi
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  2. Maria Suzanne Sabundayo
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  3. Hidetaka Miyazaki
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  4. Hidenori Mito
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  5. Hirohiko Kakizaki
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Corresponding author

Correspondence to Yasuhiro Takahashi.

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Conflicts of interest

All authors have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements), or non-financial interest (such as personal or professional relationships, affiliations, knowledge or beliefs) in the subject matter or materials discussed in this manuscript.

Ethics approval

All procedures performed in this study were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments.

Informed consent

The Institutional Review Board granted a waiver of informed consent for this study based on the ethical guidelines for medical and health research involving human subjects established by the Japanese Ministry of Education, Culture, Sports, Science, and Technology and by the Ministry of Health, Labor, and Welfare. The waiver was granted because the study was a retrospective chart review, not an interventional study, and because it was difficult to obtain consent from patients who had been treated several years ago. Nevertheless, at the request of the Institutional Review Board, we published an outline of the study, available for public viewing, on the Aichi Medical University website; this also gave patients the opportunity to decline participation in the study. None of the patients declined to participate. Personal identifiers were removed from the records prior to data analysis.

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Takahashi, Y., Sabundayo, M.S., Miyazaki, H. et al. Incarceration of the inferior oblique muscle branch of the oculomotor nerve in patients with orbital floor trapdoor fracture. Graefes Arch Clin Exp Ophthalmol 255, 2059–2065 (2017). https://doi.org/10.1007/s00417-017-3790-y

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  • DOI: https://doi.org/10.1007/s00417-017-3790-y

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