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Michael G. Stewart, MD; James R. Patrinely, MD; W. Douglas Appling, MD; David R. Jordan, MD

Arch Otolaryngol Head Neck Surg. 1995;121(6):649-652.

Abstract
Objective
Late proptosis is an unusual complication of orbital floor fracture repair. We report 12 cases and propose a classification scheme and differential diagnosis for this rare complication.

Design
Retrospective multi-institutional case review.

Setting
Two tertiary referral centers.

Results
We report 12 cases of late proptosis following orbital floor fracture repair. Causes of late proptosis include peri-implant inflammation, capsular hemorrhage, gelatin film cyst, implant infection, sino-orbital fistula, intraorbital sinus mucocele, and carotidcavernous fistula. We describe the treatment of each case individually; in most cases, the implant was removed. All 12 patients had a satisfactory outcome after treatment.

Conclusions
Proptosis presenting 2 months or more after orbital floor fracture is rare. We classify the origin of late proptosis into three groups: implant, sinus, and neurovascular. We describe the diagnosis and management of this unusual complication.

(Arch Otolaryngol Head Neck Surg. 1995;121:649-652)

Author Affiliations
From the Departments of Otorhinolaryngology and Communicative Sciences (Drs Stewart and Appling), Ophthalmology (Dr Patrinely), and Plastic Surgery (Dr Patrinely), Baylor College of Medicine, Houston, Tex; and the Oculoplastic, Orbital, and Lacrimal Service, University of Ottawa (Ontario) (Dr Jordan).

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