Learning objectives
Describe the relevant imaging anatomy of the orbit.
Describe a systematic approach to CT evaluation of blunt and penetrating trauma of the orbit.
Identify the common posttraumatic orbit lesions.
Discuss potential pitfalls and mimics that can be mistaken for posttraumatic orbit lesions.
Background
•Knowledge of the potential injuries to the eye and their imaging correlates is essential to making an accurate and rapid radiologic diagnosis of posttraumatic orbital injury.
•Computed tomography (CT) is considered to be the top choice for evaluating orbital trauma:
⇒It provides a rapid and detailed evaluation of bony structures and soft tissues of the orbit.
⇒It is also sensitive in the detection of retained metallic foreign bodies.
•Inthispresentation,Wemake asystematic approachtoassistrapidevaluationoftheorbit.
•wewillreviewthecommonpatternsoforbitalfracturesincludingfracturesof theorbitalfloor,medialwall,andorbitalroof.
•Wewillalsoreviewcomplex facial fracture patterns thatinvolvetheorbit,
toincludezygomatico-maxillarycomplex,nasoorbitoethmoid(NOE), andLeFortfracturepatterns.
Findings and procedure details
•Computed tomography (CT) is the method of choice for evaluating orbital trauma:
a.
a fast method to perform
b.
readily available
c.
no special need for patient preparation
d.
the eye movement do not degrade the image acquisition
e.no risk if metallic fragment are suspected
• Indications for Imaging in Orbital Trauma are :
* evidence of fracture on clinical examination
* limitation of EOM
* decreased visual acuity in setting of trauma
* severe pain
* inadequate examination due to soft tissue swelling.
•The...
Conclusion
•Facial traumatized patients with clinical suspicion of orbital injuries are usually firstevaluated with spiral CT.
• the best protocol is to obtain thin-section (1-3 mm) axial CT scans and then performing multiplanarReformation.
•Knowledge of diverse imaging patterns of potential injuries is essential to make a fast and accurate diagnosis of post-traumatic orbital injury.
References
1. Bair,
R.L.,
et al.
Imaging in orbital trauma.
in Seminars in ophthalmology.
1994.
Taylor & Francis.
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R.,
et al.,
Traumatic ophthalmic injuries ophthalmic injuries in mid-facial trauma: A decade long survey. Journal of Craniomaxillofacial Research,
2016.
1(4): p.
128-132.
3. Kubal,
W.S.,
Imaging of Orbital Trauma 1. Radiographics,
2008.
28(6): p.
1729-1739.
4. Lee,
H.-j.,
et al.,
CT of orbital trauma. Emergency radiology,
2004.
10(4): p.
168-172.
5. Lin,
K.Y.,
et al.,
Imaging in orbital trauma. Saudi Journal of Ophthalmology,
2012.
26(4):...