Oculocardiac reflex in a pediatric orbital floor fracture: A case report

Kamath, Abhay Taranath and Gadicherla, Srikanth and Sharma, Neha and Shukla, Anand Deep and Singh, Satpal Gill (2014) Oculocardiac reflex in a pediatric orbital floor fracture: A case report. Hellenic Archives of Oral & Maxillofacial Surgery, 15 (2). pp. 59-64.

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Abstract

Maxillofacial surgeons seldom encounter facial fractures that warrant urgent treatment. Such an indication is related to orbital floor fracture when it induces the oculocardiac reflex (OCR), a condition which clinically manifests as headache, nausea, vomiting, bradycardia and potential syncope. In the reported case, the management of bradycardia in a 5-year-old pediatric patient with an orbital blow out fracture, after a hit by a ball on the right side of his face 24 hours before, is described. Bradycardia was attributed to inferior rectus muscle entrapment, as there was no other known etiology. The patient was taken to the operating room for right orbital floor exploration and repair without any further delay. A trapdoor fracture of the right orbital floor was evident, which was treated by release of the herniated orbital contents and the entrapped inferior rectus into the correspondent maxillary sinus, followed by reconstruction of the orbital floor with AO Synthes pediatric orbital titanium mesh. On the third postoperative day there was complete resolution of the patient’s ocular disturbances, as well as of nausea, vomiting and the persistent hemodynamic instability associated with oculocardiac reflex.

Item Type: Article
Uncontrolled Keywords: Orbital floor fracture; blow-out fracture; children; muscle entrapment; bradycardia.
Subjects: Dentistry > MCODS Manipal > Oral and Maxillofacial Surgery
Depositing User: KMC Library
Date Deposited: 08 Oct 2015 09:26
Last Modified: 08 Oct 2015 09:26
URI: http://eprints.manipal.edu/id/eprint/144350

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