Traumatic Telecanthus and Posterior Lacrimal Crest Avulsion in a Six-Year-Old Child

Area of Science:

• Otolaryngology
• Pediatric Ophthalmology
• Craniofacial Surgery

Background:

• Pediatric facial fractures, particularly orbital fractures, are infrequent and may be missed.
• Delayed diagnosis or treatment of orbital fractures risks long-term sequelae.
• Limited literature exists on pediatric craniofacial fractures, especially involving orbital substructures and the lacrimal system.

Observation:

• This paper presents a rare case of an isolated posterior lacrimal crest fracture/avulsion in a 6-year-old girl following high-energy trauma.
• Injuries to the medial orbital wall can affect the medial canthal tendon, potentially causing disinsertion or rupture.
• The case highlights the need for thorough evaluation of pediatric facial trauma, including less common fracture sites.

Findings:

• The study focuses on an isolated posterior lacrimal crest fracture, a previously undocumented injury in existing literature.
• Medial orbital wall fractures can lead to medial canthal tendon issues.
• Canthopexy is identified as the primary treatment for restoring the medial canthal position and normal eyelid function.

Implications:

• This case expands the understanding of pediatric orbital and lacrimal system trauma.
• Highlights the importance of recognizing and managing rare pediatric facial fractures to avoid functional deficits.
• Emphasizes the role of surgical intervention, such as canthopexy, in managing medial canthal tendon injuries in children.