Superior Orbital Fissure Syndrome after Repair of Blow Out Fracture.

Lee, Young Bae; Kim, Chanwoo; Park, Dae Hwan

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2011;38(6):879-882.
Published online November 1, 2011.

Superior Orbital Fissure Syndrome after Repair of Blow Out Fracture.

Young Bae Lee, Chanwoo Kim, Dae Hwan Park

Department of Plastic and Reconstructive Surgery, School of Medicine, Catholic University of Daegu, Daegu, Korea. psman007@gmail.com

Abstract

PURPOSE
Superior orbital fissure syndrome is a rare neurological complex. Superior orbital fissure syndrome may result from a variety of inflammatory, infectious, neoplastic, iatrogenic, traumatic, vascular cause. The author report a patient who suffered from superior orbital fissure syndrome after inferior orbital wall reduction. METHODS: A 26-year-old female suffered from inferior orbital wall fracture with inferior gaze limitation and orbital soft tissue herniation. On posttrauma 10 day, inferior orbital wall was reduced using endoscope and porous polyethylene(Medpor(R)) was inserted. On immediate postoperation, she reported that extraocular movement was limited in almost any directions. She underwent exploration surgery to release the presence of extraocular muscle impingement. But, there was no observation of extraocular muscle impingement. On postoperative one day, high- dose steroid therapy was started to release superior orbital fissure syndrome which was defined in postoperative computed tomography.
RESULTS
After one month of high-dose steroid therapy, extraocular movement limitations improved progressively in all directions. In four months, extraocular movement recovered completely.
CONCLUSION
Superior orbital fissure syndrome may occur after surgical procedure of orbital wall reduction. Prompt diagnosis and treatment with mega-dose corticosteroid is an effective option for avoiding disaster from compressive syndrome.

Keywords: Superior orbital fissure syndrome; Orbital apex syndrome; Mega dose corticosteroid

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