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Sino-orbital fistula: two case reports
1Orbital Plastic and Lacrimal Clinic, Royal Victorian Eye and Ear Hospital, Melbourne, Australia. amcnab@medeserv.com.au
Clinical & Experimental Ophthalmology
|October 6, 2000
Summary
A rare sino-orbital fistula, a complication of orbital fracture repair, can cause intermittent symptoms. Surgical removal of implants and surrounding tissue effectively treated this condition in two patients.
Area of Science:
- Ophthalmology
- Otorhinolaryngology (ENT)
- Medical Imaging
Background:
- Orbital fractures, particularly of the orbital floor, are common injuries.
- Late complications following orbital fracture repair are infrequent but can be debilitating.
- Sino-orbital fistulas represent a rare but significant late complication.
Observation:
- Two male patients, aged 23 and 30, presented with intermittent symptoms including globe displacement, diplopia, and discomfort.
- Symptoms manifested months after surgical repair of an orbital floor fracture using a synthetic implant.
- Symptoms were consistently triggered by actions such as nose blowing.
Findings:
- A fistula connecting the paranasal sinuses and the orbit was diagnosed in both patients.
- The intermittent symptoms were attributed to air passage from the sinuses into the orbit.
- Both patients achieved complete symptom resolution following surgical intervention.
Implications:
- Sino-orbital fistula is a rare but possible complication of orbital floor fracture repair with synthetic implants.
- Prompt diagnosis and surgical management, including implant and pseudocapsule removal, are crucial for successful treatment.
- This case highlights the importance of considering rare complications in patients with persistent or recurrent symptoms after orbital surgery.