Oculocardiac reflex in an adult with a trapdoor orbital floor fracture: Case report, literature review, and differential diagnosis

Bernardo Ferreira Brasileiro, Joseph E. van Sickels, Larry L. Cunningham

Research output: Contribution to journalReview articlepeer-review

2 Scopus citations

Abstract

Orbital floor blowout fractures can result in a variety of signs and symptoms depending on the severity of the bone defect. Large defects often result in enophthalmos and restriction of ocular movement; yet the timing of surgery can be delayed up to two weeks with good functional outcomes. In contrast, an orbital trapdoor defect with entrapment of the inferior rectus muscle usually elicits pain with marked restriction of the upward gaze and activation of the oculocardiac reflex without significant dystopia or enophthalmos. When autonomic cardiac derangement is diagnosed along with an orbital floor fracture, it has been suggested that the fracture should be treated immediately. Otherwise, it will result in continued hemodynamic instability and muscular injury and may require a second surgery. This article reports the management of an unusual presentation of a trapdoor blowout orbital floor fracture surgery with oculocardiac response in an adult, with emphasis on its pathophysiology, management, and differential diagnosis.

Original languageEnglish
Pages (from-to)428-434
Number of pages7
JournalJournal of the Korean Association of Oral and Maxillofacial Surgeons
Volume46
Issue number6
DOIs
StatePublished - Dec 2020

Bibliographical note

Publisher Copyright:
Copyright © 2020 The Korean Association of Oral and Maxillofacial Surgeons. All rights reserved.

Keywords

  • Facial injuries
  • Oculocardiac reflex
  • Orbital fractures

ASJC Scopus subject areas

  • Surgery
  • Oral Surgery

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