• Silvia Soare, Jean-Marc Foletti, Audrey Gallucci, Charles Collet, Laurent Guyot, and Cyrille Chossegros.
• Service de chirurgie maxillo-faciale, Hôpital de la Timone, 264 rue St Pierre, 13385, Marseille, France; Aix-Marseille Université, Jardin du Pharo - 58, bd Charles Livon, 13284, Marseille Cedex 07, France. Electronic address: lssylvia@yahoo.com.
• J Craniomaxillofac Surg. 2015 Sep 1; 43 (7): 1000-3.

IntroductionBlindness is a rare and severe complication of craniofacial trauma. The management of acute orbital compartment syndrome (AOCS) is not well defined and there is no standard treatment. Our objective was to find indications for orbital decompression, the best time for treatment, and the appropriate techniques.Materials And MethodsA literature review was made from articles published between 1994 and 2014 in the PubMed database, on the emergency treatment of AOCS.Results59 of the 89 patients treated surgically for AOCS presented with significant improvement of visual acuity (VA) after orbital decompression. The delay between trauma and surgery was short. A lateral canthotomy with inferior cantholysis (LCIC) was the most frequently used technique.DiscussionAOCS with a risk of visual impairment must be decompressed in emergency, at best in the 2 hours following trauma, most often by LCIC to have the best chance of recovering VA. Adjuvant medical treatment (acetazolamide, mannitol, corticosteroids) should not delay surgery. Postoperative corticosteroid therapy is not indicated, especially in patients with severe head trauma.Copyright © 2015 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

17 keywords...

hide…