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Traumatic Globe Rupture and Herniation Into the Maxillary Sinus Daniel Thomas Ginat, M.D., M.S.*, and Suzanne K. Freitag, M.D.† *Department of Radiology, University of Chicago, Chicago, Illinois, U.S.A.; and †Department of Ophthalmology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, Massachusetts, U.S.A.

FIG. 1. Coronal CT image showing partial herniation of the left globe (arrow) into the maxillary sinus.

T

he patient is a 59-year-old man who incurred a left orbit injury by an opponent’s thumb during a rugby match. A coronal image from the noncontrast CT obtained at the time of the patient’s presentation shows partial herniation of the left globe (Fig. 1) and orbital contents in the maxillary sinus through a large orbital floor fracture. Vitreous hemorrhage and disorganization of intraocular contents are also evident on CT, which raised suspicion for globe rupture. Indeed, the patient was found to have a Zone 3 rupture on surgical exploration.

Fractures of the orbit most commonly manifest as an orbital floor blowout, which may result from trauma to the inferior orbital rim, causing disruption of the thin bone of the floor from the transmitted force. However, concomitant globe rupture and herniation into the maxillary sinus is very rare. Both likely occurred in this case because the mechanism of injury was direct downward pressure from a thumb on the globe itself, causing the globe to rupture and to be pushed through the orbital floor.

Accepted for publication July 1, 2014 The authors have no financial or conflicts of interest to disclose. Address correspondence and reprint requests to Daniel Thomas Ginat, M.D., M.S., Department of Radiology, University of Chicago, 5841 S Maryland Avenue, Chicago, IL 60637. E-mail: [email protected] DOI: 10.1097/IOP.0000000000000283

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Ophthal Plast Reconstr Surg, Vol. 30, No. 6, 2014

Traumatic globe rupture and herniation into the maxillary sinus.

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