Treatment of Severe Blepharoptosis after Blow Out Fracture.

Kim, Nam Hun; Yang, Jeong Yeol; Moon, Jae Won; Kim, Gyu Bo; Cheon, Ji Seon

Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(4):461-464.
Published online July 1, 2010.

Treatment of Severe Blepharoptosis after Blow Out Fracture.

Nam Hun Kim, Jeong Yeol Yang, Jae Won Moon, Gyu Bo Kim, Ji Seon Cheon

Department of Plastic and Reconstructive Surgery, Chosun University College of Medicine, Gwangju, Korea. jyyang@chosun.ac.kr

Abstract

PURPOSE
Blepharoptosis can result from either congenital or acquired causes. Blow out fracture or facial bone fracture including blow out fracture can be one of the causes. Authors experienced 3 cases of severe blepharoptosis after blow out fracture treated only with observation after reduction of associated fracture. METHODS: Reconstruction of orbital wall was conducted on all cases diagnosed as blow out fracture using 3 dimensional computed tomography, and conservative treatment was done on accompanying severe blepharoptosis.
RESULTS
At the time of injury, all cases showed severe blepharoptosis requiring frontalis muscle transfer for correction. But blepharoptosis was recovered in an average of 18 weeks without any surgical procedure except reconstruction of orbital wall.
CONCLUSION
Once Blepharoptosis occurred after blow out fracture, thorough evaluation must be done at first. If definitive cause of blepahroptisis cannot be found as authors' cases, injury of oculomotor nerve may result in blepharoptosis. So, as for blepharoptosis after blow out fracture, conservative treatment following reconstruction of fractured orbital wall can be one of good management.

Keywords: Blow out fracture; Blepharoptosis