Orbital Structure Involvement in Midface Fractures Impacting Ocular Injury at a Tertiary Hospital in Eastern Indonesia

Abstract

Introduction: The midface is a complex anatomical area consisting of several areas. Although various factors protect the eye from trauma, such as orbital rim, blink reflex, elasticity of ocular structures, and protective eye movements by hands and head, ocular injuries remain common in patients with midface fractures, with an incidence rate of up to 90.6%. This study, the first of its kind conducted in Indonesia, aims to evaluate the characteristics and incidence of ocular injuries in midface fractures and to examine the relationship between the treatment. Methods: This observational analytic study employed a retrospective cohort design, utilizing medical record data of midface fracture patients. The independent variables included age, sex, cause, incidence, segment and severity of ocular injury, number of orbital wall involvements, and treatment options. The dependent variable was midface fracture patients. The Mann–Whitney and Fisher’s exact tests were employed to analyze the multivariate data. Results: Individuals aged 32–37 were most commonly affected due to accidents, with the anterior ocular segment and maxilla bone frequently affected. There are no special factors that differentiate a person from experiencing an ocular injury in a midface fracture (P > 0.05). Ocular injuries correlated with orbital wall injury (P = 0.008) at least one discontinuity. Impaired functions included movement and visual disturbances, diplopia, and dystopia (P = 0.134). Conclusions: No significant relationship was found between age, sex, and cause of trauma with ocular injuries in patients with midface fractures. However, a significant relationship was observed between the amount of orbital rim involvement and at least one wall discontinuity occurring in midface fracture patients.

Keywords

• maxillofacial
• midface fracture
• ocular injury
• traffic accident