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Article
June 1995

Late Proptosis Following Orbital Floor Fracture Repair

Author Affiliations

From the Departments of Otorhinolaryngology and Communicative Sciences (Drs Stewart and Appling), Ophthalmology (Dr Patrinely), and Plastic Surgery (Dr Patrinely), Baylor College of Medicine, Houston, Tex; and the Oculoplastic, Orbital, and Lacrimal Service, University of Ottawa (Ontario) (Dr Jordan).

Arch Otolaryngol Head Neck Surg. 1995;121(6):649-652. doi:10.1001/archotol.1995.01890060047009
Abstract

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 carotidcavernous 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.(Arch Otolaryngol Head Neck Surg. 1995;121:649-652)

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