Intact Periorbita Can Prevent Post-Traumatic Enophthalmos Following a Large Orbital Blow-Out Fracture

Srinivas Susarla; Richard A Hopper; Ezgi Mercan

doi:10.1177/1943387520903545

Intact Periorbita Can Prevent Post-Traumatic Enophthalmos Following a Large Orbital Blow-Out Fracture

Craniomaxillofac Trauma Reconstr. 2020 Mar;13(1):49-52. doi: 10.1177/1943387520903545. Epub 2020 Mar 23.

Authors

Srinivas Susarla^{1

2}, Richard A Hopper¹, Ezgi Mercan¹

Affiliations

¹ Division of Plastic Surgery, Department of Surgery, University of Washington School of Medicine, Seattle, WA, USA.
² Department of Oral and Maxillofacial Surgery, University of Washington School of Dentistry, Seattle, WA, USA.

Abstract

Treatment of orbital floor fractures is predicated on the restoration of orbital volume to prevent enophthalmos or hypoglobus. Globe position is the result of a complex interplay between the bony orbital anatomy and the soft tissue envelope. Studies on orbital fractures have frequently suggested criteria for repair on the basis of bony defect size or volume change. In this report, we describe a case of a large orbital floor defect (4.8 cm²) with intact periorbita and no herniation of soft tissue contents in a young male following facial trauma. The patient was followed for 1-year clinically and did not develop enophthalmos. This case demonstrates that bony injury alone is not sufficient to produce enophthalmos, and that the interplay between the soft tissue and bony anatomy is a critical determinant of globe position following orbital trauma.

Keywords: enophthalmos; inferior rectus morphology; orbital floor fracture.