![]() Fractures to the superior wall are less common, but they can happen alone or in combination with damage to the other two areas. The superior wall, or roof, of the eye socket is formed by a part of the frontal bone, or forehead.Blunt trauma to the nose or eye region is a common cause of fractures to the medial wall. The medial wall is formed primarily by the ethmoid bone that separates your nasal cavity from your brain.They can be damaged by a blow to the cheek or side of the face. Many important nerves run through this area. The zygomatic bone also forms the temporal, or outer, side wall of the eye socket.This could be from a fist, a blunt object, or a car accident. Fractures to the inferior floor most commonly come from a blow to the side of the face. The inferior wall, or orbital floor, is formed by the upper jawbone (maxilla), part of the cheek bone (zygomatic), and a small part of the hard palate (palatine bone).You can have a fracture in one or all of these parts of the eye socket: The eye socket is divided into four parts. Also inside the socket are your tear glands, cranial nerves, blood vessels, ligaments, and other nerves. The eye socket contains your eyeball and all the muscles that move it. Seven different bones make up the socket. No difference between 5-7 days vs.The eye socket, or orbit, is the bony cup surrounding your eye.Fractures of medial and inferior walls may be considered open fractures into sinus mucosa.Check for associated infraorbital nerve injury.Shows cloudy maxillary sinus representing blood, fluid or tissue.Otherwise can obtain Waters' view first.Look for teardrop sign on coronal view of CT.Obtain orbital CT as initial study if significant clinical findings.Example of a typical fracture involving the right orbital floor (green arrow) and medial maxillary sinus wall (red arrow), which is associated with resultant hemorrhage and an air-fluid level in the right maxillary sinus (blue star). Head CT image with maxillary sinus opacification on coronal (left) and sagittal (right) non-contrast head CT images. Paralysis of extraocular motions, ptosis, periorbital anesthesiaĭifferential Diagnosis Maxillofacial Trauma.May result in injury to oculomotor and ophthalmic divisions of CN V.Extrusion of intraocular contents, severe conjunctival hemorrhage, a tear-shaped pupil.Exophthalmos, decreasing visual acuity, increased ocular pressure.Retrobulbar hematoma or malignant orbital emphysema.Epiphora (tears spilling over lower lid)įindings suggestive of ocular involvement.Entrapment of inf rectus or inf oblique or orbital fat.Infraorbital anesthesia (damage to infraorbital nerve from orbital floor fracture).Orbital fracture with right eye entrapment. Often accompanied by injury to lacrimal duct, dural tears, and traumatic brain injury.Associated with force applied to nasal bridge.Lateral, inferior, and superior orbital ridge fracture typically occurs with other facial fractures.Adipose tissue, inferior rectus or inferior oblique can entrap within maxillary or ethmoid sinus.Fracture of inferior or medial orbital walls with out fracture of orbital ridge.Lateral blow out fractures require higher force.Medial wall consists of thin lamina papyracea, requires intermediate energy.Thin inferior wall frequently injured, requires less energy.2.3 Findings suggestive of ocular involvement. ![]()
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