Journal of Otorhinolaryngology and Facial Plastic Surgery

Vol. 10 No. 1 (2024)

Orbital Apex Syndrome Without Facial Fractures: A Case Report and Review of Literature

Journal of Otorhinolaryngology and Facial Plastic Surgery, Vol. 10 No. 1 (2024), 13 March 2024 , Page 1-10
https://doi.org/10.22037/orlfps.v10i1.45669

Abstract

Background: Orbital Apex Syndrome (OAS) is an extremely rare yet significant complication following craniomaxillofacial trauma. The syndrome's clinical features predominantly involve a combination of vision loss and ophthalmoplegia. Despite the severity of its implications, there is scant literature addressing traumatic OAS without associated facial bone fractures.

Case presentation: We present the case of a young adult male who experienced traumatic OAS without facial bone fractures following a head injury from an assault. The patient exhibited ptosis, complete ophthalmoplegia in the left eye, and visual acuity impairment. Diagnostic imaging revealed comminuted fractures of the anterior sphenoid bone and slight narrowing of the optic canal, but no involvement of the intraconal region or other craniofacial injuries. The patient was managed conservatively with close monitoring. While there was some improvement in extraocular muscle movements, the visual impairment persisted.

Conclusion: A comprehensive literature search identified two studies that met the inclusion criteria for traumatic OAS without facial bone fractures or severe traumatic brain injuries. Treatment approaches ranged from observation to high-dose corticosteroids and surgical optic canal decompression. However, visual acuity remained impaired regardless of the treatment type. The variability in outcomes underscores the need for a standardized treatment protocol. Traumatic OAS without facial bone fractures presents a complex clinical challenge with variable progression and mixed treatment outcomes. Early and accurate diagnosis, individualized treatment plans, and a multidisciplinary approach are essential for improving patient prognosis. Further research is necessary to establish a unified treatment protocol for managing this rare condition.

Keywords:
  • Traumatic Orbital Apex Syndrome (OAS); Traumatic Optic Neuropathy (TON); Ophthalmoplegia; Traumatic Superior Orbital Fissure Syndrome; Isolated Traumatic OAS.

How to Cite

Hasheminia , A., Malik , M. A., Rezaei , M., & Fattahi, T. (2024). Orbital Apex Syndrome Without Facial Fractures: A Case Report and Review of Literature . Journal of Otorhinolaryngology and Facial Plastic Surgery, 10(1), 1–10. https://doi.org/10.22037/orlfps.v10i1.45669

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