Frequency of Diplopia and its Management in Patients with Midfacial Fractures at A Tertiary Institute of Dentistry

Abstract

Objective: To determine the frequency of diplopia and its various management options in midfacial fractures. Study Design: Cross-sectional study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi Pakistan, from Apr 2017 to Apr 2019. Methodology: All patients who presented with midfacial fractures were included in the study. Patients were categorized into 6 age-groups. All patients underwent CT scan of the skull and a forced duction test was performed. Patients with a positive forced duction test underwent early repair surgically either with open reduction and internal fixation or closed reduction. Conversely, patients who had a negative forced duction test were treated conservatively if there was no other indication for early surgical repair. Results: Out of 80 patients, 69(86.3%) were males. Diplopia was present in 16(20%) patients and forced duction test was positive in 9(56.25%). Sixty-five (81.3%) patients were managed surgically and 15(18.8%) conservatively. Resolution of diplopia was also significantly associated with early surgical intervention (p<0.01). One patient who presented after 3 weeks of injury did not have any resolution of diplopia even after 3 weeks of surgery. Conclusion: Diplopia was commonly found in midfacial fractures due to trauma. Early presentation and surgical intervention were associated with better outcomes.

Keywords

• Closed reduction, Diplopia, Midfacial bone fractures, Open reduction and fixation.