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Published in: Japanese Journal of Ophthalmology 1/2015

01-01-2015 | Clinical Investigation

Orbital blowout fracture location in Japanese and Chinese patients

Authors: Michelle T. Sun, Wencan Wu, Akihide Watanabe, Hirohiko Kakizaki, Ben Chen, Kosuke Ueda, Nobutada Katori, Yasuhiro Takahashi, Dinesh Selva

Published in: Japanese Journal of Ophthalmology | Issue 1/2015

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Abstract

Purpose

To characterize the location of orbital blowout fractures in Asian individuals.

Methods

This was a retrospective review of 470 consecutive Asian patients with orbital blowout fractures who presented to four tertiary care hospitals in Japan and China. Computed tomography (CT) characterized the location and severity of fractures involving the medial wall, the orbital floor, and/or the maxilloethmoidal strut.

Results

A total of 475 orbital blowout fractures were identified. More than one fracture location was involved in 19 % of all cases. The medial orbital wall was the most commonly involved location, presenting in 29 cases (61 %), of which 204 (43 %) were isolated medial blowout fractures. The orbital floor was the second most common location involved, present in 226 cases (48 %) with 150 isolated orbital floor fractures (32 %), while the maxilloethmoidal strut was involved in 45 cases (9 %) with 30 of those being isolated strut fractures (6 %). The majority of fractures (62 %) were classified as moderately severe, whilst 14 % were mild, and 24 % were severe. Associated nasal fractures were present in 16 % of the cases.

Conclusions

Orbital blowout fractures in Japanese and Chinese individuals occur most commonly in the medial wall. This is in contrast to previous reports on white individuals, who tend to sustain fractures involving the orbital floor rather than the medial wall.
Literature
1.
go back to reference Gosau M, Schoneich M, Draenert FG, Ettl T, Driemel O, Reichert TE. Retrospective analysis of orbital floor fractures: complications, outcome, and review of literature. Clin Oral Investig. 2011;15:305–13.PubMedCrossRef Gosau M, Schoneich M, Draenert FG, Ettl T, Driemel O, Reichert TE. Retrospective analysis of orbital floor fractures: complications, outcome, and review of literature. Clin Oral Investig. 2011;15:305–13.PubMedCrossRef
2.
3.
go back to reference Chi MJ, Ku M, Shin KH, Baek S. An analysis of 733 surgically treated blowout fractures. Ophthalmologica. 2010;224:167–75.PubMedCrossRef Chi MJ, Ku M, Shin KH, Baek S. An analysis of 733 surgically treated blowout fractures. Ophthalmologica. 2010;224:167–75.PubMedCrossRef
4.
go back to reference Jones DE, Evans JN. “Blow-out” fractures of the orbit: an investigation into their anatomical basis. J Laryngol Otol. 1967;81:1109–20.PubMedCrossRef Jones DE, Evans JN. “Blow-out” fractures of the orbit: an investigation into their anatomical basis. J Laryngol Otol. 1967;81:1109–20.PubMedCrossRef
5.
go back to reference Gittinger JW Jr, Hughes JP, Suran EL. Medial orbital wall blow-out fracture producing an acquired retraction syndrome. J Clin Neuroophthalmol. 1986;6:153–6.PubMedCrossRef Gittinger JW Jr, Hughes JP, Suran EL. Medial orbital wall blow-out fracture producing an acquired retraction syndrome. J Clin Neuroophthalmol. 1986;6:153–6.PubMedCrossRef
6.
go back to reference Jank S, Schuchter B, Emshoff R, Strobl H, Koehler J, Nicasi A, et al. Clinical signs of orbital wall fractures as a function of anatomic location. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:149–53.PubMedCrossRef Jank S, Schuchter B, Emshoff R, Strobl H, Koehler J, Nicasi A, et al. Clinical signs of orbital wall fractures as a function of anatomic location. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;96:149–53.PubMedCrossRef
7.
go back to reference Burm JS, Chung CH, Oh SJ. Pure orbital blowout fracture: new concepts and importance of medial orbital blowout fracture. Plast Reconstr Surg. 1999;103:1839–49.PubMedCrossRef Burm JS, Chung CH, Oh SJ. Pure orbital blowout fracture: new concepts and importance of medial orbital blowout fracture. Plast Reconstr Surg. 1999;103:1839–49.PubMedCrossRef
8.
go back to reference Song WK, Lew H, Yoon JS, Oh MJ, Lee SY. Role of medial orbital wall morphologic properties in orbital blow-out fractures. Invest Ophthalmol Vis Sci. 2009;50:495–9.PubMedCrossRef Song WK, Lew H, Yoon JS, Oh MJ, Lee SY. Role of medial orbital wall morphologic properties in orbital blow-out fractures. Invest Ophthalmol Vis Sci. 2009;50:495–9.PubMedCrossRef
9.
go back to reference Yano H, Nakano M, Anraku K, Suzuki Y, Ishida H, Murakami R, et al. A consecutive case review of orbital blowout fractures and recommendations for comprehensive management. Plast Reconstr Surg. 2009;124:602–11.PubMedCrossRef Yano H, Nakano M, Anraku K, Suzuki Y, Ishida H, Murakami R, et al. A consecutive case review of orbital blowout fractures and recommendations for comprehensive management. Plast Reconstr Surg. 2009;124:602–11.PubMedCrossRef
10.
go back to reference Merle H, Gerard M, Raynaud M. Isolated medial orbital blow-out fracture with medial rectus entrapment. Acta Ophthalmol Scand. 1998;76:378–9.PubMedCrossRef Merle H, Gerard M, Raynaud M. Isolated medial orbital blow-out fracture with medial rectus entrapment. Acta Ophthalmol Scand. 1998;76:378–9.PubMedCrossRef
11.
go back to reference Maisel RH, Acomb TE, Cantrell RW. Medial orbital blow-out fracture: a case report. Laryngoscope. 1975;85:1211–5.PubMedCrossRef Maisel RH, Acomb TE, Cantrell RW. Medial orbital blow-out fracture: a case report. Laryngoscope. 1975;85:1211–5.PubMedCrossRef
12.
go back to reference He D, Blomquist PH, Ellis E III. Association between ocular injuries and internal orbital fractures. J Oral Maxillofac Surg. 2007;65:713–20.PubMedCrossRef He D, Blomquist PH, Ellis E III. Association between ocular injuries and internal orbital fractures. J Oral Maxillofac Surg. 2007;65:713–20.PubMedCrossRef
13.
go back to reference Park JS, Lew H, Lee SY. Role of inferior orbital wall morphologic properties in isolated orbital blow-out fracture. Ophthalmic Res. 2012;47:1–6.PubMedCrossRef Park JS, Lew H, Lee SY. Role of inferior orbital wall morphologic properties in isolated orbital blow-out fracture. Ophthalmic Res. 2012;47:1–6.PubMedCrossRef
14.
go back to reference Cheng AC, Lucas PW, Yuen HK, Lam DS, So KF. Surgical anatomy of the Chinese orbit. Ophthal Plast Reconstr Surg. 2008;24:136–41.PubMedCrossRef Cheng AC, Lucas PW, Yuen HK, Lam DS, So KF. Surgical anatomy of the Chinese orbit. Ophthal Plast Reconstr Surg. 2008;24:136–41.PubMedCrossRef
15.
go back to reference Ahmad F, Kirkpatrick NA, Lyne J, Urdang M, Waterhouse N. Buckling and hydraulic mechanisms in orbital blowout fractures: fact or fiction? J Craniofac Surg. 2006;17:438–41.PubMedCrossRef Ahmad F, Kirkpatrick NA, Lyne J, Urdang M, Waterhouse N. Buckling and hydraulic mechanisms in orbital blowout fractures: fact or fiction? J Craniofac Surg. 2006;17:438–41.PubMedCrossRef
Metadata
Title
Orbital blowout fracture location in Japanese and Chinese patients
Authors
Michelle T. Sun
Wencan Wu
Akihide Watanabe
Hirohiko Kakizaki
Ben Chen
Kosuke Ueda
Nobutada Katori
Yasuhiro Takahashi
Dinesh Selva
Publication date
01-01-2015
Publisher
Springer Japan
Published in
Japanese Journal of Ophthalmology / Issue 1/2015
Print ISSN: 0021-5155
Electronic ISSN: 1613-2246
DOI
https://doi.org/10.1007/s10384-014-0357-x

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