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Ocular Injuries in Patients of Zygomatico-Complex (ZMC) Fractures

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Journal of Maxillofacial and Oral Surgery Aims and scope Submit manuscript

Abstract

Purpose

Mid face injuries commonly destroy the integrity of the orbital skeleton, and are frequently complicated by injury to the eye, ranging between 2.7 and 90.6 % as reported in literature. The eye injuries range from simple subconjunctival haemorrhage to globe rupture. The paper aims to study the types of ocular injuries in patients with ZMC fractures.

Patients and Methods

A study of 67 patients, who had sustained facial trauma sufficient to lead to a facial bone fracture, was undertaken in the department of Oral and Maxillofacial Surgery, Govt Dental College, Srinagar from 2008 to 2014 and the patients received a comprehensive examination by an ophthalmologist within 1 week of injury. All the patients sustaining confirmed ZMC fracture were examined by an ophthalmologist for any associated ocular injury. A thorough ophthalmologic examination included assessment of visual acuity, pupillary reactivity, anterior and posterior segment examination and extraocular motility. The variables reviewed included patient’s gender, mechanism of injury, visual acuity, pupillary reactivity, extra ocular motility, presence or absence of diplopia, ocular and orbital findings, and intraorbital hypoesthesia.

Results

The most common etiology of trauma was RTA (64.1 %), followed by falls (14.9 %) in our study. In our study 83.5 % of the patients were males. Minor ocular injuries such as subconjunctival haemorrhage and corneal injury accounted for most of the cases. Subconjunctival haemorrhage was the most common injury, present in 86.5 % of the cases. Hyphema was present 13.4 %, vitreous haemorrhage 2.98 %, retinal haemorrhage 1.49 %, corneal abrasion 4.47 %, mydriasis 1.49 %, choroidal rupture 5.97 %, retinal detachment 2.98 %, decreased visual activity 13.4 %, retinal tear and angle recession was present 7.46 % times.

Conclusion

ZMC fractures are associated with higher incidence of ocular injuries. The incidence of traumatic optic neuropathy and other ocular injuries warrants a prompt ophthalmologic examination of all patients with ZMC fractures as quickly as possible to prevent morbidity.

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References

  1. Ashar A, Kovacs A, Khan S, Hakim J (1998) Blindness associated with midfacial fractures. J Oral Maxillofac Surg 56:1146–1150

    Article  CAS  PubMed  Google Scholar 

  2. Al-Qurainy IA, Stassen LF, Dutton GN, Moos KF, El-Attar A (1991) The characteristics of midfacial fractures and the association with ocular injury: a prospective study. Br J Oral Maxillofac Surg 29:291–301

    Article  CAS  PubMed  Google Scholar 

  3. Amrith S, Lim TC, Saw SM, Lee TK (2000) Ophthalmic involvement in craniomaxillofacial trauma. J Craniomaxillofac Surg 28(3):140–147

    Article  CAS  PubMed  Google Scholar 

  4. Jelks GW, La Trentra G (1987) Orbital fractures. In: Foster CA, Sherman JE (eds) Surgery of facial bone fractures. Churchill Livingston, New York, pp 67–91

    Google Scholar 

  5. Fonseca RJ (ed) (1991) Oral and maxillofacial trauma. W B Saunders, Philadelphia

    Google Scholar 

  6. Ellis E (2005) Fractures of the zygomatic complex and arch. In: Fonseca RJ, Walker RV, Betts NJ (eds) Oral and maxillofacial trauma, vol 1, 3rd edn. Saunders Elsevier, Philadelphia, pp 583–594

    Google Scholar 

  7. Dutton GN, Al-Qurainy AI (1997) Ophthalmic consequences of maxillofacial injuries. In: Fonseca RJ, Walker RV (eds) Oral and maxillofacial trauma, 2nd edn. W. B. Saunders Company, Pennsylvania.

  8. Holt GR, Holt JE (1983) Incidence of eye injuries in facial fractures: an analysis of 727 cases. Otolaryngol Head Neck Surg 91:276–279

    Article  CAS  PubMed  Google Scholar 

  9. Bailey W, Kuo P, Evans L (1993) Diagnosis and treatment of retrobulbar hemorrhage. J Oral Maxillofac Surg 51(7):780–782

    Article  CAS  PubMed  Google Scholar 

  10. Girotto J, Gamble W, Robertson B, Redett R, Muehlberger T, Mayer M, Zinreich J, Iliff N, Miller N, Manson P (1998) Blindness after reduction of facial fractures. Plast Reconstr Surg 102(6):1821–1834

    Article  CAS  PubMed  Google Scholar 

  11. Tadji A et al (2003) Fractured zygomas. ANS J Surg 73:49–54

    Article  Google Scholar 

  12. Gray PB, Leen MM, Loftus MJ (1993) Late retro bulbar hemorrhage and blindness following malar fracture complicated by factor XI deficiency. J Oral Maxillofac Surg 51:699–702

    Article  CAS  PubMed  Google Scholar 

  13. Karyouti SM (1987) Maxillofacial injuries in Jordan University hospital. Int J Oral Maxillofac Surg 16:262–265

    Article  CAS  PubMed  Google Scholar 

  14. Ajagbe HA, Daramola JO (1980) Pattern of facial bone fracture seen at University College Hospital, Ibadan, Nigeria. East Afr Med J 57:267–272

    CAS  PubMed  Google Scholar 

  15. Oji C (1999) Jaw fractures in Enugu, Nigeria, 1985–1995. Br J Oral Maxillofac Surg 37:106–109

    Article  CAS  PubMed  Google Scholar 

  16. Guly CM, Guly HR, Bouamra O, Gray RH, Lecky FE (2006) Ocular injuries in patients with major trauma. Emerg Med J 23:915

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Ansari MH (2005) Blindness after facial fractures: a 19-year retrospective study. J Oral Maxillofac Surg 63:229–237

    Article  PubMed  Google Scholar 

  18. Koo L, Hatton MP, Rubin PA (2007) Traumatic blindness after a displaced lateral orbital wall fracture. J Trauma Acute Care Surg 62:1288–1289

    Article  Google Scholar 

  19. Popat H, Doyle PT, Davies SJ (2007) Blindness following retrobulbar haemorrhage: it can be prevented. Br J Oral Maxillofac Surg 45:163–164

    Article  CAS  PubMed  Google Scholar 

  20. Lam LK, Lim LH, Moore MH et al (1993) Associated injuries in facial fractures: review of 839 patients. Br J Plast Surg 46:635

    Article  PubMed  Google Scholar 

  21. Jamal BT, Pfahler SM, Lane KA, Bilyk JR, Pribitkin EA, Diecidue RJ et al (2009) Ophthalmic injuries in patients with zygomaticomaxillary complex fractures requiring surgical repair. J Oral Maxillofac Surg 67:986–989

    Article  PubMed  Google Scholar 

  22. Nabeela R, Asad AC, Riaz AW, Saba H, Chinar KA, Shammas RK (2014) Ophthalmic injuries in orbito-zygomatic fractures. J Coll Physic Surg Pak 24(9):649–652

    Google Scholar 

  23. Jayamanne DG, Gillie RF (1996) Do patients with facial trauma to the orbito-zygomatic region also sustain significant ocular injuries? J R Coll Surg Edinb 41:200–203

    CAS  PubMed  Google Scholar 

  24. Brown S, Ky W, Lisman RD (1999) Concomitant ocular injuries with orbital fractures. J Craniomaxillofac Trauma 5:41–43

    CAS  PubMed  Google Scholar 

  25. Ansari MH (2005) Blindness after facial fractures: a 19 year retrospective study. J Oral Maxillofac Surg 63:229–237

    Article  PubMed  Google Scholar 

  26. Wood GD (1986) Blindness following fracture of zygomatic bone. Br J Oral Maxillofac Surg 24:12–16

    Article  CAS  PubMed  Google Scholar 

  27. Dilip S, Newaskar VP, Deepak A, Shailnder T (2014) Etiology incidence and pattern of mid face fractures and associated ocular injuries. J Maxillofac Oral Surg 13(2):115–119

    Article  Google Scholar 

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Authors and Affiliations

  1. Oral and Maxillofacial Surgery, Govt Dental College, Srinagar, (Jammu and Kashmir), India

    Altaf Hussain Malik, Aijaz A. Shah, Irshad Ahmad & Babar Ai Shah

Authors
  1. Altaf Hussain Malik
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  2. Aijaz A. Shah
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  3. Irshad Ahmad
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  4. Babar Ai Shah
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Correspondence to Altaf Hussain Malik.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional/departmental research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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A proper informed consent was obtained from the patients on an approved consent form.

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Malik, A.H., Shah, A.A., Ahmad, I. et al. Ocular Injuries in Patients of Zygomatico-Complex (ZMC) Fractures. J. Maxillofac. Oral Surg. 16, 243–247 (2017). https://doi.org/10.1007/s12663-016-0907-5

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  • DOI: https://doi.org/10.1007/s12663-016-0907-5

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