Traumatic Brain Injury and Its Association With Orbital Fracture Characteristics and Repair

Area of Science:

• Neurosurgery
• Trauma Surgery
• Ophthalmology

Background:

• Traumatic brain injury (TBI) frequently co-occurs with facial fractures.
• Orbital fractures represent a significant portion of all facial fractures, increasing TBI risk.
• Understanding TBI prevalence and impact in orbital fracture patients is crucial for optimal care.

Purpose of the Study:

• To determine the prevalence of TBI in patients undergoing orbital fracture repair (OFR).
• To identify risk factors associated with TBI in this patient population.
• To assess the influence of TBI on the timing of OFR.

Main Methods:

• Retrospective review of 200 trauma patients undergoing OFR between 2015 and 2020.
• Exclusion criteria: patients under 18 and those with unreported Glasgow Coma Scale (GCS).
• TBI defined as GCS <15 or any neurological symptom; categorized as mild, moderate, or severe.

Main Results:

• Nearly half (49.5%) of patients presented with concomitant TBI.
• Orbital roof and lateral wall fractures were more common in TBI patients.
• Severe TBI was significantly associated with delayed OFR (>60 days post-injury).

Conclusions:

• Craniofacial surgeons should actively screen for TBI in all facial trauma cases.
• Patients with orbital roof and lateral wall fractures warrant particular attention for potential TBI.
• Prompt TBI diagnosis and management are essential, especially considering its impact on surgical timing.