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Facial Plast Surg 2022; 38(03): 274-278
DOI: 10.1055/s-0041-1740290
Original Research

Displaced Orbital Fractures with Concurrent Orbital Compartment Syndrome: A Case-Based Systematic Review

Serge Zogheib 
1   Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
,
Georges Sukkarieh
2   Department of Ophthalmology, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
,
Georges Mjaess 
1   Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
,
Samer Abou Zeid
1   Department of Plastic, Reconstructive and Cranio-Maxillo-Facial Surgery, Hotel Dieu de France University Hospital, Faculty of Medicine, Saint Joseph University, Beirut, Lebanon
› Author Affiliations Funding None.
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Abstract

Orbital compartment syndrome (OCS) is an emergency that complicates intra-orbital, retrobulbar hemorrhage in most cases. Bony orbital decompression is an effective treatment for OCS, and displaced orbital fractures are protective. Nevertheless, in rare cases, OCS occurs despite a displaced orbital fracture. The aim of the current review is to present its pathophysiology and management based on what is published in the medical literature, and our center's experience. A systematic review of literature was conducted through PubMed, Medline, Embase, and Cochrane from inception through February 2021. The following search query was used: “orbital fracture” and “trauma” and “orbital compartment syndrome.” Studies tackling the pathophysiology and management of concurrent displaced orbital fracture with OCS were included and a cohort of patients was constituted. A cohort of 18 cases reported in the literature were included (49.3 ± 30.6 years, 50% M). Given that OCS occurs with or without orbital fracture, pathophysiology of OCS is mostly explained by the division of the orbital fat into many compartments, due to the presence of Koorneef's fibrous septa. Management of OCS in such circumstances consisted of inferior-lateral canthotomy and cantholysis in 50% of cases, subperiosteal drainage with myringotomy in 22.2% of cases, subperiosteal drainage in 16.7% of cases, and complete lateral cantholysis in 16.7% of cases. Two cases who presented to our tertiary care center were also added to this review. Physicians should be aware that OCS can occur even with displaced fractures of the orbital cavity. When clinical suspicion is present, an emergent management is needed.

Keywords

orbital compartment syndrome - orbital fracture - canthotomy - cantholysis - trauma

Patient Consent

Both patients have signed a written informed consent form to the inclusion of material pertaining to themselves. They acknowledge that they cannot be identified via the paper, and that they are fully anonymized.




Publication History

Article published online:
14 December 2021

© 2021. Thieme. All rights reserved.

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