Abstract

Volume.126 Number.11

Original article : Clinical science

Pathological Observations of an Orbital Inferior Wall Fracture
Sohei Shimasaki1, Sakiko Miura2, Hidetoshi Onda1
1 Department of Ophthalmology, Showa University School of Medicine
2 Department of Pathology and Laboratory Medicine, Showa University School of Medicine

Purpose: In cases of orbital inferior wall fractures, irreversible ocular motility disorder can occur due to adhesion between orbital fat and surrounding tissues because of bleeding and inflammatory reactions at the site of the fracture. We histopathologically observed the adherent tissue taken from the site of the orbital inferior wall fracture and investigated the wound healing process. Herein, we report the optimal time of surgery from a histopathological point of view.
Patients and method: We included seven patients with orbital inferior wall fractures who underwent surgery between 2018 and 2020 at the Showa University East Hospital. Tissues were dissected from the orbital fat at the site of the fracture during surgery with the aim of pathologically examining them. The tissues were stained with hematoxylin and eosin before microscopic observation, and the findings were evaluated by a pathologist.
Results: The inflammatory reaction gradually decreased as the number of days after injury increased, and the adhesion between the orbital fat and the maxillary sinus mucosa gradually progressed, leading to scarring over approximately 3 months.
Conclusions: By histopathologically evaluating the tissue from the site of the orbital inferior wall fracture, the optimal time of surgery was determined. Even without any ocular motility disorder early in the injury, surgery prior to adhesion and scar formation is desirable.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 126: 976-982,2022.

Key words
Orbital inferior wall fracture, Ocular motility disorder, Pathological examination, Adhesions, Scar formation
Reprint requests to
Sohei Shimasaki, M. D. Department of Ophthalmology, Showa University School of Medicine. 2-14-19 Nishinakanobu, Shinagawa-ku, Tokyo 142-0054, Japan