Orbital medial wall blow-out fracture

Case contributed by Dr Shervin Sharifkashani

Presentation

Facial trauma and right side eyelids swelling, orbital pain, and the eye limitation of abduction.

Patient Data

Age: 35 years
Gender: Male

Right orbital medial wall blow-out fracture with fat and medial rectus muscle hernia within the fracture gap, preseptal and postseptal emphysema more severe in eyelids, and preseptal and lacrimal gland soft tissue swelling are seen. Minimally displaced fracture in the right orbital floor with submucosal hemorrhage in the roof of the right maxillary sinus is noted. Hemorrhage within right side ethmoidal air cells is also seen. Right eye corneal tear is noted.

Case Discussion

The case illustrates non-contrast MDCT features of orbital medial wall blow-out fracture with entrapment of medial rectus muscle within the fracture gap and eyelids and orbital emphysema. One of the major complications of orbital medial wall fracture is an extension within the ethmoid roof and CSF leakage.

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