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Late proptosis following orbital floor fracture repair
M G Stewart1, J R Patrinely, W D Appling
1Department of Otorhinolaryngology, Baylor College of Medicine, Houston, Tex., USA.
Objective:
Late proptosis is an unusual complication of orbital floor fracture repair. We report 12 cases and propose a classification scheme and differential diagnosis for this rare complication.
Design:
Retrospective multi-institutional case review.
Setting:
Two tertiary referral centers.
Results:
We report 12 cases of late proptosis following orbital floor fracture repair. Causes of late proptosis include peri-implant inflammation, capsular hemorrhage, gelatin film cyst, implant infection, sino-orbital fistula, intraorbital sinus mucocele, and carotid-cavernous fistula. We describe the treatment of each case individually; in most cases, the implant was removed. All 12 patients had a satisfactory outcome after treatment.
Conclusions:
Proptosis presenting 2 months or more after orbital floor fracture is rare. We classify the origin of late proptosis into three groups: implant, sinus, and neurovascular. We describe the diagnosis and management of this unusual complication.