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Specific Issues in Pediatric Periocular Trauma

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Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery

Abstract

Ocular and periocular injuries can cause significant morbidity. Periocular injuries occur in 5% of all serious injuries, according to the United States Eye Injury Registry, and the majority of these involve the canaliculus (81%) and/or the eyelid (70%) [1]. Not surprisingly, the majority of these injuries occur in children (23% in 0–9-year-olds) and teenagers (18% in 10–19-year-olds).

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References

  1. Long JA, Tann TM. Eyelid and lacrimal trauma. In: Kuhn F, Pieramici DJ, editors. Ocular trauma. New York: Thieme; 2002.

    Google Scholar 

  2. Weiss HB, Friedman DI, Coben JH. Incidence of dog bite injuries treated in emergency departments. JAMA. 1998;279(1):51–3.

    Article  CAS  PubMed  Google Scholar 

  3. Cornwell JM. Dog bite prevention: responsible pet ownership and animal safety. J Am Vet Med Assoc. 1997;210(8):1147–8.

    CAS  PubMed  Google Scholar 

  4. Beck AM, Jones BA. Unreported dog bites in children. Public Health Rep. 1985;100(3):315–21.

    CAS  PubMed Central  PubMed  Google Scholar 

  5. Burroughs JR, Soparkar CN, Patrinely JR, et al. Periocular dog bite injuries and responsible care. Ophthalmic Plast Reconstr Surg. 2002;18(6):416–19; discussion 9–20.

    Article  Google Scholar 

  6. Sacks JJ, Lockwood R, Hornreich J, Sattin RW. Fatal dog attacks, 1989–1994. Pediatrics. 1996;97(6 Pt 1):891–5.

    CAS  PubMed  Google Scholar 

  7. Wulc AE, Arterberry JF. The pathogenesis of canalicular laceration. Ophthalmology. 1991;98(8):1243–9.

    Article  CAS  PubMed  Google Scholar 

  8. Botek AA, Goldberg SH. Management of eyelid dog bites. J Craniomaxillofac Trauma. 1995;1(2):18–24.

    CAS  PubMed  Google Scholar 

  9. Jordan DR, Ziai S, Gilberg SM, Mawn LA. Pathogenesis of canalicular lacerations. Ophthalmic Plast Reconstr Surg. 2008;24(5):394–8.

    Article  Google Scholar 

  10. White WL, Glover AT, Buckner AB, Hartshorne MF. Relative canalicular tear flow as assessed by dacryoscintigraphy. Ophthalmology. 1989;96(2):167–9.

    Article  CAS  PubMed  Google Scholar 

  11. Murgatroyd H, Craig JP, Sloan B. Determination of relative contribution of the superior and inferior canaliculi to the lacrimal drainage system in health using the drop test. Clin Exp Ophthalmol. 2004;32(4):404–10.

    Article  Google Scholar 

  12. Barahimi B, Murchison AP, Bilyk JR. Forget me not. Surv Ophthalmol. 2010;55(5):467–80.

    Article  PubMed  Google Scholar 

  13. Slonim CB. Dog bite-induced canalicular lacerations: a review of 17 cases. Ophthalmic Plast Reconstr Surg. 1996;12(3):218–22.

    Article  CAS  Google Scholar 

  14. Bailie WE, Stowe EC, Schmitt AM. Aerobic bacterial flora of oral and nasal fluids of canines with reference to bacteria associated with bites. J Clin Microbiol. 1978;7(2):223–31.

    CAS  PubMed Central  PubMed  Google Scholar 

  15. Talan DA, Citron DM, Abrahamian FM, et al. Bacteriologic analysis of infected dog and cat bites. Emergency Medicine Animal Bite Infection Study Group. N Engl J Med. 1999;340(2):85–92.

    Article  CAS  PubMed  Google Scholar 

  16. Savar A, Kirszrot J, Rubin PA. Canalicular involvement in dog bite related eyelid lacerations. Ophthalmic Plast Reconstr Surg. 2008;24(4):296–8.

    Article  Google Scholar 

  17. Lion C, Escande F, Burdin JC. Capnocytophaga canimorsus infections in human: review of the literature and cases report. Eur J Epidemiol. 1996;12(5):521–33.

    Article  CAS  PubMed  Google Scholar 

  18. Hawes MJ, Segrest DR. Effectiveness of bicanalicular silicone intubation in the repair of canalicular lacerations. Ophthalmic Plast Reconstr Surg. 1985;1(3):185–90.

    Article  CAS  Google Scholar 

  19. Kersten RC, Kulwin DR. “One-stitch” canalicular repair. A simplified approach for repair of canalicular laceration. Ophthalmology. 1996;103(5):785–9.

    Article  CAS  PubMed  Google Scholar 

  20. Hatton MP, Watkins LM, Rubin PA. Orbital fractures in children. Ophthalmic Plast Reconstr Surg. 2001;17(3):174–9.

    Article  CAS  Google Scholar 

  21. McGraw BL, Cole RR. Pediatric maxillofacial trauma. Age-related variations in injury. Arch Otolaryngol Head Neck Surg. 1990;116(1):41–5.

    Article  CAS  PubMed  Google Scholar 

  22. Maisel H. Postnatal growth and anatomy of the face. In: Mathog RH, editor. Maxillofacial trauma. Baltimore: Willimas & Wilkins; 1984.

    Google Scholar 

  23. Koltai PJ, Amjad I, Meyer D, Feustel PJ. Orbital fractures in children. Arch Otolaryngol Head Neck Surg. 1995;121(12):1375–9.

    Article  CAS  PubMed  Google Scholar 

  24. Chapman VM, Fenton LZ, Gao D, Strain JD. Facial fractures in children: unique patterns of injury observed by computed tomography. J Comput Assist Tomogr. 2009;33(1):70–2.

    Article  PubMed  Google Scholar 

  25. Fulcher TP, Sullivan TJ. Orbital roof fractures: management of ophthalmic complications. Ophthalmic Plast Reconstr Surg. 2003;19(5):359–63.

    Article  Google Scholar 

  26. Rowe NL. Fractures of the facial skeleton in children. J Oral Surg. 1968;26(8):505–15.

    CAS  PubMed  Google Scholar 

  27. Khosla M, Boren W. Mandibular fractures in children and their management. J Oral Surg. 1971;29(2):116–21.

    CAS  PubMed  Google Scholar 

  28. Grant 3rd JH, Patrinely JR, Weiss AH, et al. Trapdoor fracture of the orbit in a pediatric population. Plast Reconstr Surg. 2002;109(2):482–9; discussion 90–5.

    Article  PubMed  Google Scholar 

  29. Jordan DR, Allen LH, White J, et al. Intervention within days for some orbital floor fractures: the white-eyed blowout. Ophthalmic Plast Reconstr Surg. 1998;14(6):379–90.

    Article  CAS  Google Scholar 

  30. Kulwin DR, Leadbetter MG. Orbital rim trauma causing a blowout fracture. Plast Reconstr Surg. 1984;73(6):969–71.

    Article  CAS  PubMed  Google Scholar 

  31. Raflo GT. Blow-in and blow-out fractures of the orbit: clinical correlations and proposed mechanisms. Ophthalmic Surg. 1984;15(2):114–9.

    CAS  PubMed  Google Scholar 

  32. Smith B, Regan Jr WF. Blow-out fracture of the orbit; mechanism and correction of internal orbital fracture. Am J Ophthalmol. 1957;44(6):733–9.

    CAS  PubMed  Google Scholar 

  33. Fujino T, Makino K. Entrapment mechanism and ocular injury in orbital blowout fracture. Plast Reconstr Surg. 1980;65(5):571–6.

    Article  CAS  PubMed  Google Scholar 

  34. Anderson RL, Panje WR, Gross CE. Optic nerve blindness following blunt forehead trauma. Ophthalmology. 1982;89(5):445–55.

    Article  CAS  PubMed  Google Scholar 

  35. Bansagi ZC, Meyer DR. Internal orbital fractures in the pediatric age group: characterization and management. Ophthalmology. 2000;107(5):829–36.

    Article  CAS  PubMed  Google Scholar 

  36. Parbhu KC, Galler KE, Li C, Mawn LA. Underestimation of soft tissue entrapment by computed tomography in orbital floor fractures in the pediatric population. Ophthalmology. 2008;115(9):1620–5.

    Article  PubMed  Google Scholar 

  37. McInnes AW, Burnstine MA. White-eyed medial wall orbital blowout fracture. Ophthalmic Plast Reconstr Surg. 2010;26(1):44–6.

    Article  Google Scholar 

  38. Tse R, Allen L, Matic D. The white-eyed medial blowout fracture. Plast Reconstr Surg. 2007;119(1):277–86.

    Article  CAS  PubMed  Google Scholar 

  39. Brannan PA, Kersten RC, Kulwin DR. Isolated medial orbital wall fractures with medial rectus muscle incarceration. Ophthalmic Plast Reconstr Surg. 2006;22(3):178–83.

    Article  Google Scholar 

  40. Lane K, Penne RB, Bilyk JR. Evaluation and management of pediatric orbital fractures in a primary care setting. Orbit. 2007;26(3):183–91.

    Article  PubMed  Google Scholar 

  41. Smith B, Lisman RD, Simonton J, Della Rocca R. Volkmann’s contracture of the extraocular muscles following blowout fracture. Plast Reconstr Surg. 1984;74(2):200–16.

    Article  CAS  PubMed  Google Scholar 

  42. Egbert JE, May K, Kersten RC, Kulwin DR. Pediatric orbital floor fracture: direct extraocular muscle involvement. Ophthalmology. 2000;107(10):1875–9.

    Article  CAS  PubMed  Google Scholar 

  43. Cohen SM, Garrett CG. Pediatric orbital floor fractures: nausea/vomiting as signs of entrapment. Otolaryngol Head Neck Surg. 2003;129(1):43–7.

    Article  PubMed  Google Scholar 

  44. Wachler BS, Holds JB. The missing muscle syndrome in blowout fractures: an indication for urgent surgery. Ophthalmic Plast Reconstr Surg. 1998;14(1):17–8.

    Article  CAS  Google Scholar 

  45. Burnstine MA. Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis. Ophthalmology. 2002;109(7):1207–10; discussion 10–1; quiz 12–3.

    Article  PubMed  Google Scholar 

  46. Sires BS, Stanley Jr RB, Levine LM. Oculocardiac reflex caused by orbital floor trapdoor fracture: an indication for urgent repair. Arch Ophthalmol. 1998;116(7):955–6.

    CAS  PubMed  Google Scholar 

  47. Lane KA, Bilyk JR, Taub D, Pribitkin EA. “Sutureless” repair of orbital floor and rim fractures. Ophthalmology. 2009;116(1):135–8; e2.

    Article  PubMed  Google Scholar 

  48. Hall EJ, Brenner DJ. Cancer risks from diagnostic radiology. Br J Radiol. 2008;81(965):362–78.

    Article  CAS  PubMed  Google Scholar 

  49. Brenner DJ, Hall EJ. Computed tomography–an increasing source of radiation exposure. N Engl J Med. 2007;357(22):2277–84.

    Article  CAS  PubMed  Google Scholar 

  50. Brenner DJ, Hricak H. Radiation exposure from medical imaging: time to regulate? JAMA. 2010;304(2):208–9.

    Article  CAS  PubMed  Google Scholar 

  51. Shah NB, Platt SL. ALARA: is there a cause for alarm? Reducing radiation risks from computed tomography scanning in children. Curr Opin Pediatr. 2008;20(3):243–7.

    Article  PubMed  Google Scholar 

  52. Brody AS, Frush DP, Huda W, Brent RL. Radiation risk to children from computed tomography. Pediatrics. 2007;120(3):677–82.

    Article  PubMed  Google Scholar 

  53. Amis Jr ES, Butler PF, Applegate KE, et al. American College of Radiology white paper on radiation dose in medicine. J Am Coll Radiol. 2007;4(5):272–84.

    Article  PubMed  Google Scholar 

  54. Mettler Jr FA, Wiest PW, Locken JA, Kelsey CA. CT scanning: patterns of use and dose. J Radiol Prot. 2000;20(4):353–9.

    Article  PubMed  Google Scholar 

  55. Frush DP, Applegate K. Computed tomography and radiation: understanding the issues. J Am Coll Radiol. 2004;1(2):113–9.

    Article  PubMed  Google Scholar 

  56. Linton OW, Mettler Jr FA. National conference on dose reduction in CT, with an emphasis on pediatric patients. AJR Am J Roentgenol. 2003;181(2):321–9.

    Article  PubMed  Google Scholar 

  57. Frush DP. Pediatric dose reduction in computed tomography. Health Phys. 2008;95(5):518–27.

    Article  CAS  PubMed  Google Scholar 

  58. Shelsta HN, Bilyk JR, Rubin PA, et al. Wooden intraorbital foreign body injuries: clinical characteristics and outcomes of 23 patients. Ophthalmic Plast Reconstr Surg. 2010;26(4):238–44.

    Article  Google Scholar 

  59. Larson DB, Rader SB, Forman HP, Fenton LZ. Informing parents about CT radiation exposure in children: it’s OK to tell them. AJR Am J Roentgenol. 2007;189(2):271–5.

    Article  PubMed  Google Scholar 

  60. Boncoeur-Martel MP, Adenis JP, Rulfi JY, et al. CT appearances of chronically retained wooden intraorbital foreign bodies. Neuroradiology. 2001;43(2):165–8.

    Article  CAS  PubMed  Google Scholar 

  61. Macrae JA. Diagnosis and management of a wooden orbital foreign body: case report. Br J Ophthalmol. 1979;63(12):848–51.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  62. Nasr AM, Haik BG, Fleming JC, et al. Penetrating orbital injury with organic foreign bodies. Ophthalmology. 1999;106(3):523–32.

    Article  CAS  PubMed  Google Scholar 

  63. Miller CF, Brodkey JS, Colombi BJ. The danger of intracranial wood. Surg Neurol. 1977;7(2):95–103.

    CAS  PubMed  Google Scholar 

  64. Nishio Y, Hayashi N, Hamada H, et al. A case of delayed brain abscess due to a retained intracranial wooden foreign body: a case report and review of the last 20 years. Acta Neurochir (Wien). 2004;146(8):847–50.

    CAS  Google Scholar 

  65. Michon J, Liu D. Intraorbital foreign bodies. Semin Ophthalmol. 1994;9(3):193–9.

    Article  CAS  PubMed  Google Scholar 

  66. Fulcher TP, McNab AA, Sullivan TJ. Clinical features and management of intraorbital foreign bodies. Ophthalmology. 2002;109(3):494–500.

    Article  PubMed  Google Scholar 

  67. Ho VT, McGuckin Jr JF, Smergel EM. Intraorbital wooden foreign body: CT and MR appearance. AJNR Am J Neuroradiol. 1996;17(1):134–6.

    CAS  PubMed  Google Scholar 

  68. Lagalla R, Manfre L, Caronia A, et al. Plain film, CT and MRI sensibility in the evaluation of intraorbital foreign bodies in an in vitro model of the orbit and in pig eyes. Eur Radiol. 2000;10(8):1338–41.

    Article  CAS  PubMed  Google Scholar 

  69. Glatt HJ, Custer PL, Barrett L, Sartor K. Magnetic resonance imaging and computed tomography in a model of wooden foreign bodies in the orbit. Ophthalmic Plast Reconstr Surg. 1990;6(2):108–14.

    Article  CAS  Google Scholar 

  70. Woolfson JM, Wesley RE. Magnetic resonance imaging and computed tomographic scanning of fresh (green) wood foreign bodies in dog orbits. Ophthalmic Plast Reconstr Surg. 1990;6(4):237–40.

    Article  CAS  Google Scholar 

  71. Smely C, Orszagh M. Intracranial transorbital injury by a wooden foreign body: re-evaluation of CT and MRI findings. Br J Neurosurg. 1999;13(2):206–11.

    Article  CAS  PubMed  Google Scholar 

  72. McGuckin Jr JF, Akhtar N, Ho VT, et al. CT and MR evaluation of a wooden foreign body in an in vitro model of the orbit. AJNR Am J Neuroradiol. 1996;17(1):129–33.

    PubMed  Google Scholar 

  73. Dalley RW. Intraorbital wood foreign bodies on CT: use of wide bone window settings to distinguish wood from air. AJR Am J Roentgenol. 1995;164(2):434–5.

    Article  CAS  PubMed  Google Scholar 

  74. Finkelstein M, Legmann A, Rubin PA. Projectile metallic foreign bodies in the orbit: a retrospective study of epidemiologic factors, management, and outcomes. Ophthalmology. 1997;104(1):96–103.

    Article  CAS  PubMed  Google Scholar 

  75. Holt GR, Holt JE. Management of orbital trauma and foreign bodies. Otolaryngol Clin North Am. 1988;21(1):35–52.

    CAS  PubMed  Google Scholar 

  76. Braun J, Gdal-On M, Goldsher D, et al. Traumatic carotid aneurysm secondary to cavernous sinus penetration by wood: CT features. J Comput Assist Tomogr. 1987;11(3):525–8.

    Article  CAS  PubMed  Google Scholar 

  77. Doucet TW, Harper DW, Rogers J. Penetrating orbital foreign body with intracranial involvement. Ann Ophthalmol. 1983;15(4):325–7.

    CAS  PubMed  Google Scholar 

  78. Cunningham EJ, Albani B, Masaryk TJ, Rasmussen PA. Temporary balloon occlusion of the cavernous carotid artery for removal of an orbital and intracranial foreign body: case report. Neurosurgery. 2004;55(5):1225.

    Article  PubMed  Google Scholar 

  79. Jacobs NA, Morgan LH. On the management of retained airgun pellets: a survey of 11 orbital cases. Br J Ophthalmol. 1988;72(2):97–100.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  80. Danesh-Meyer HV, Savino PJ, Bilyk JR, et al. Gaze-evoked amaurosis produced by intraorbital buckshot pellet. Ophthalmology. 2001;108(1):201–6.

    Article  CAS  PubMed  Google Scholar 

  81. Mutlukan E, Fleck BW, Cullen JF, Whittle IR. Case of penetrating orbitocranial injury caused by wood. Br J Ophthalmol. 1991;75(6):374–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

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Correspondence to Jurij R. Bilyk M.D. .

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Murchison, A.P., Matthews, A.E., Bilyk, J.R. (2012). Specific Issues in Pediatric Periocular Trauma. In: Black, E., Nesi, F., Calvano, C., Gladstone, G., Levine, M. (eds) Smith and Nesi’s Ophthalmic Plastic and Reconstructive Surgery. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-0971-7_73

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