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  • Title: Different onset pattern of oculocardiac reflex in pediatric medial wall blowout fractures.
    Author: Kosaka M, Sakamoto T, Yamamichi K, Yamashiro Y.
    Journal: J Craniofac Surg; 2014 Jan; 25(1):247-52. PubMed ID: 24406587.
    Abstract:
    PURPOSE: We report the 2 pediatric patients who had radiographic confirmation of a rare case of medial orbital wall "trapdoor" fracture with extraordinary symptoms of oculocardiac reflex (OCR). METHODS: This was a small interventional case series. RESULTS: This is the retrospective report of 2 boys (13 and 10 years old) who developed diplopia, pain, nausea/vomiting, and general malaise following blunt trauma. However, the onset pattern of OCR was absolutely different: delayed onset of OCR just following therapeutic forced duction test to treat the orbital content herniation in the first case and a sudden onset after injury in the second case. In both cases, urgent surgery led to complete normalization of ocular motility. CONCLUSIONS: Prompt diagnosis and proper treatment are critical to maximize clinical outcome for this rare and critical trauma.
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