Cranial Maxillofac Trauma Reconstruction 2017; 10(01): 11-15
DOI: 10.1055/s-0036-1584395
Original Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Interdisciplinary Management of Minimally Displaced Orbital Roof Fractures: Delayed Pulsatile Exophthalmos and Orbital Encephalocele

Austin Y. Ha1, William Mangham2, Sarah A. Frommer3, David Choi4, Petra Klinge4, Helena O. Taylor5, Adetokunbo A. Oyelese4, Stephen R. Sullivan5
  • 1Division of Plastic and Reconstructive Surgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
  • 2Department of Neurosurgery, The Warren Alpert Medical School of Brown University, Providence, Rhode Island
  • 3Department of Plastic and Reconstructive Surgery, Rhode Island Hospital, Providence, Rhode Island
  • 4Department of Neurosurgery, Rhode Island Hospital, Providence, Rhode Island
  • 5Division of Plastic and Reconstructive Surgery, Mount Auburn Hospital, Cambridge, Massachusetts
Further Information

Publication History

30 October 2015

20 February 2016

Publication Date:
15 September 2016 (eFirst)

Abstract

Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. They are typically associated with severe mechanisms of injury and may be associated with significant neurologic or ophthalmologic compromise including traumatic brain injury and vision loss. Rarely, traumatic encephalocele or pulsatile exophthalmos may be present at the time of injury or develop in delayed fashion, necessitating close observation of these patients. In this article, we describe two patients with minimally displaced blow-in type orbital roof fractures that were later complicated by orbital encephalocele and pulsatile exophthalmos, prompting urgent surgical intervention. We also suggest a management algorithm for adult patients with orbital roof fractures, emphasizing careful observation and interdisciplinary management involving plastic surgery, neurosurgery, and ophthalmology.