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Different onset pattern of oculocardiac reflex in pediatric medial wall blowout fractures
Masaaki Kosaka1, Tadayoshi Sakamoto, Kohsaku Yamamichi
1From the Department of Plastic Surgery, Fukuoka Sanno Hospital, Fukuoka, Japan.
Purpose:
We report the 2 pediatric patients who had radiographic confirmation of a rare case of medial orbital wall "trapdoor" fracture with extraordinary symptoms of oculocardiac reflex (OCR).
Methods:
This was a small interventional case series.
Results:
This is the retrospective report of 2 boys (13 and 10 years old) who developed diplopia, pain, nausea/vomiting, and general malaise following blunt trauma. However, the onset pattern of OCR was absolutely different: delayed onset of OCR just following therapeutic forced duction test to treat the orbital content herniation in the first case and a sudden onset after injury in the second case. In both cases, urgent surgery led to complete normalization of ocular motility.
Conclusions:
Prompt diagnosis and proper treatment are critical to maximize clinical outcome for this rare and critical trauma.
