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Diplopia in facial fractures.
P Siritongtaworn1, S Tongsawas, S Siltharm
1Department of Surgery, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Journal of the Medical Association of Thailand = Chotmaihet Thangphaet
|February 21, 2002
Summary
Orbital fractures can cause diplopia (double vision), with orbital floor fractures being the most common cause. Early surgical repair of orbital fractures leads to better outcomes and resolution of diplopia.
Area of Science:
- Ophthalmology
- Trauma Surgery
- Maxillofacial Surgery
Background:
- Facial fractures, particularly those involving the orbit, can lead to significant visual complications such as diplopia.
- Understanding the incidence and causes of diplopia in orbital fracture patients is crucial for effective treatment planning.
Purpose of the Study:
- To investigate the incidence of diplopia in patients with orbital fractures.
- To identify the types of orbital fractures most commonly associated with diplopia.
- To evaluate the effectiveness of surgical repair on diplopia resolution.
Main Methods:
- A prospective study of 675 facial fracture patients treated between January 1997 and December 1998.
- Detailed recording of fracture types, presence of diplopia, surgical interventions, and outcomes for 256 orbital fracture cases.
- Surgical repair using silastic sheeting or titanium mesh, depending on fracture severity.
Main Results:
- Diplopia was present in 17 out of 256 orbital fracture cases (6.64%).
- Orbital floor fractures were the most frequent cause of diplopia (8 cases).
- Surgical repair resolved diplopia in 14 patients; 3 cases of persistent minimal diplopia were associated with old fractures.
Conclusions:
- Diplopia is a notable complication of orbital fractures, with orbital floor fractures being the primary etiology.
- Early surgical intervention for orbital fractures is associated with improved outcomes and higher rates of diplopia resolution compared to late repair.