Journal of the Japan Society of Cranio-Maxillo-Facial Surgery
Online ISSN : 2433-7838
Print ISSN : 0914-594X
Case Report
A Case of Orbital Medial Wall Fracture, with Missing Rectus Sign, That Showed Postoperative Extraocular Muscle Paralysis
Kei KOIZUMIKaoru SASAKIMasahiro SASAKIJunya OSHIMAYukiko AIHARAMitsuru SEKIDO
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2022 Volume 38 Issue 3 Pages 106-112

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Abstract

  Orbital linear fracture with muscle entrapment is known to often result in prolonged postoperative diplopia and limited ocular motility, when early surgery is not possible; however, there are few reports of extraocular muscle paralysis after orbital fracture. We experienced a case of extraocular muscle paralysis following orbital linear fracture surgery, which was performed the day after injury. An 11-year-old girl visited the hospital due to left-side facial trauma. Following the event, she exhibited nausea and adduction disorder of her left eye. Simple computed tomography revealed orbital medial wall fracture with missing rectus sign. She was referred to our department the following day, and surgery was performed on the same day. Thirteen days after the operation, her left eye showed limitation of adduction, and excyclotropia, suggestive of medial rectus muscle paralysis. By her 8-month follow-up examination, ocular motility had recovered. In trapdoor fractures with entrapped extraocular muscle, it is important to perform surgery as soon as possible, and postoperative muscle paralysis is a complication of which physicians should be aware.

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© 2022 Japan Society of Cranio-Maxillo-Facial Surgery
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