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Case #8

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Demographics: 23 years old, Male
Indication: Trauma

Findings

  • Right globe rupture with internal and retrobulbar hemorrhage as well as right proptosis with stretched appearance of the optic nerve
  • Acute complex right nasoorbitoethmoid fracture with comminuted fractures of the nasal arches, nasal septum, ethmoid air cell septae, medial orbital wall, and frontal sinus. There is likely also a nondisplaced cribriform plate fracture given trace pneumocephalus along the crista galli
  • Acute right inferior and medial orbital wall blowout fractures with herniation of orbital fat through the orbital floor defect but no extraocular muscle herniation. There is, however, rounding of both inferior and medial rectus muscles. Notable involvement of the nasolacrimal canal and infraorbital foramen
  • Right orbital floor fracture extends into the anterior wall of the maxillary sinus with multiple osseous fragments protruding into the sinus and associated hemosinus
  • Polyp/mucous retention cyst in the left maxillary sinus

Diagnosis

Globe rupture

Sample Report

Right globe rupture with internal and retrobulbar hemorrhage as well as right proptosis with stretched appearance of the optic nerve. Findings raise concern for optic nerve injury.

Acute complex right nasoorbitoethmoid fracture with comminuted fractures of the nasal arches, nasal septum, ethmoid air cell septae, medial orbital wall, and frontal sinus. There is likely also a nondisplaced cribriform plate fracture given trace pneumocephalus along the crista galli.

Acute right inferior and medial orbital wall blowout fractures with herniation of orbital fat through the orbital floor defect but no extraocular muscle herniation. There is, however, rounding of both inferior and medial rectus muscles. Recommend correlation with clinical signs of entrapment. Notable involvement of the nasolacrimal canal and infraorbital foramen.

Right orbital floor fracture extends into the anterior wall of the maxillary sinus with multiple osseous fragments protruding into the sinus and associated hemosinus.

Discussion

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