Abstract
In cases of severe oral and maxillofacial trauma, intracranial injuries can sometimes occur, often resulting in significant sequelae. Among these, oculomotor nerve palsy is characterized by impaired eye movement except for abduction, dilated pupils, and ptosis. This condition is important for oral and maxillofacial surgeons handling such trauma cases. We experienced a case of severe oral and maxillofacial trauma in an 83-year-old man, who developed residual oculomotor nerve palsy as a sequela. We report the case with a brief review of the literature. The patient sustained multiple head and maxillofacial injuries due to a fallen tree during a logging operation. Detailed imaging of the entire body revealed a fracture of the right temporal bone, a middle cranial fossa fracture, traumatic subarachnoid hemorrhage, and pneumocephalus. He was referred to our department for surgery to address the panfacial fractures and underwent open reduction and internal fixation under general anesthesia. Additionally, the patient presented with left ptosis, left dilated pupils, and impaired left eye movement. Based on these symptoms, he was diagnosed with traumatic left oculomotor nerve palsy and was monitored by both the neurosurgery and ophthalmology departments. Detailed imaging suggested that injury near the dural perforation of the cavernous sinus was suspected to be the cause of this disease. In oral and maxillofacial trauma cases, close cooperation with related departments is essential for prompt and appropriate diagnosis and treatment of such conditions.
