Oculocardiac Reflex in an Orbital Fracture without Entrapment
Abstract Large orbital fractures in older patients are infrequently associated with an exaggerated oculocardiac reflex. We present a patient in their 5th decade with a large right orbital floor and medial wall fracture without radiographic evidence of extraocular muscle compression or entrapment who...
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| Veröffentlicht in: | Journal of oral and maxillofacial surgery 2017-08, Vol.75 (8), p.1716-1721 |
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| container_title | Journal of oral and maxillofacial surgery |
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| creator | Woernley, Timothy C., D.D.S Wright, Thomas L., D.M.D Lam, Duc N., D.D.S Jundt, Jonathon S., D.D.S., M.D |
| description | Abstract Large orbital fractures in older patients are infrequently associated with an exaggerated oculocardiac reflex. We present a patient in their 5th decade with a large right orbital floor and medial wall fracture without radiographic evidence of extraocular muscle compression or entrapment who experienced severe nausea and bradycardia with movement of his affected eye. The patient exhibited bradycardia to 17 beats per minute during the initial examination and was taken emergently to the OR for reconstruction of the right orbital floor and medial wall. Additional episodes of bradycardia intraoperatively were responsive to glycopyrrolate. After the procedure, the patient’s pain was reduced, a normal range of motion was restored, and the bradycardia and nausea resolved. An explanation for induction of the oculocardiac reflex is considered in the absence of clinical or radiological entrapment as large orbital fractures are not often considered to induce this reflex. |
| doi_str_mv | 10.1016/j.joms.2017.03.014 |
| format | Article |
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We present a patient in their 5th decade with a large right orbital floor and medial wall fracture without radiographic evidence of extraocular muscle compression or entrapment who experienced severe nausea and bradycardia with movement of his affected eye. The patient exhibited bradycardia to 17 beats per minute during the initial examination and was taken emergently to the OR for reconstruction of the right orbital floor and medial wall. Additional episodes of bradycardia intraoperatively were responsive to glycopyrrolate. After the procedure, the patient’s pain was reduced, a normal range of motion was restored, and the bradycardia and nausea resolved. An explanation for induction of the oculocardiac reflex is considered in the absence of clinical or radiological entrapment as large orbital fractures are not often considered to induce this reflex.</description><identifier>ISSN: 0278-2391</identifier><identifier>EISSN: 1531-5053</identifier><identifier>DOI: 10.1016/j.joms.2017.03.014</identifier><identifier>PMID: 28412263</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Dentistry ; Eye Movements - physiology ; Heart Rate - physiology ; Humans ; Imaging, Three-Dimensional ; Male ; Orbit - diagnostic imaging ; Orbit - surgery ; Orbital Fractures - diagnostic imaging ; Orbital Fractures - physiopathology ; Orbital Fractures - surgery ; Reflex, Oculocardiac - physiology ; Surgery ; Tomography, X-Ray Computed</subject><ispartof>Journal of oral and maxillofacial surgery, 2017-08, Vol.75 (8), p.1716-1721</ispartof><rights>2017</rights><rights>Published by Elsevier Inc.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-e43cd49fecfeacbbff04e141751bade20d7ad042d80d5c2d4c9351b44f5417c03</citedby><cites>FETCH-LOGICAL-c411t-e43cd49fecfeacbbff04e141751bade20d7ad042d80d5c2d4c9351b44f5417c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0278239117303324$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27903,27904,65309</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/28412263$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Woernley, Timothy C., D.D.S</creatorcontrib><creatorcontrib>Wright, Thomas L., D.M.D</creatorcontrib><creatorcontrib>Lam, Duc N., D.D.S</creatorcontrib><creatorcontrib>Jundt, Jonathon S., D.D.S., M.D</creatorcontrib><title>Oculocardiac Reflex in an Orbital Fracture without Entrapment</title><title>Journal of oral and maxillofacial surgery</title><addtitle>J Oral Maxillofac Surg</addtitle><description>Abstract Large orbital fractures in older patients are infrequently associated with an exaggerated oculocardiac reflex. We present a patient in their 5th decade with a large right orbital floor and medial wall fracture without radiographic evidence of extraocular muscle compression or entrapment who experienced severe nausea and bradycardia with movement of his affected eye. The patient exhibited bradycardia to 17 beats per minute during the initial examination and was taken emergently to the OR for reconstruction of the right orbital floor and medial wall. Additional episodes of bradycardia intraoperatively were responsive to glycopyrrolate. After the procedure, the patient’s pain was reduced, a normal range of motion was restored, and the bradycardia and nausea resolved. An explanation for induction of the oculocardiac reflex is considered in the absence of clinical or radiological entrapment as large orbital fractures are not often considered to induce this reflex.</description><subject>Adult</subject><subject>Dentistry</subject><subject>Eye Movements - physiology</subject><subject>Heart Rate - physiology</subject><subject>Humans</subject><subject>Imaging, Three-Dimensional</subject><subject>Male</subject><subject>Orbit - diagnostic imaging</subject><subject>Orbit - surgery</subject><subject>Orbital Fractures - diagnostic imaging</subject><subject>Orbital Fractures - physiopathology</subject><subject>Orbital Fractures - surgery</subject><subject>Reflex, Oculocardiac - physiology</subject><subject>Surgery</subject><subject>Tomography, X-Ray Computed</subject><issn>0278-2391</issn><issn>1531-5053</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2017</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kU1v1DAQhi0EotvCH-CAcuSSMGM7m0QCpKpqC1Kllfg4W854IhzysdgO0H9Poi0cOHCawzzvK80zQrxAKBBw_7ov-nmMhQSsClAFoH4kdlgqzEso1WOxA1nVuVQNnonzGHsAxLLaPxVnstYo5V7txNsDLcNMNjhvKfvI3cC_Mj9ldsoOofXJDtlNsJSWwNlPn77OS8qupxTsceQpPRNPOjtEfv4wL8SXm-vPV-_zu8Pth6vLu5w0YspZK3K66Zg6ttS2XQeaUWNVYmsdS3CVdaClq8GVJJ2mRq0rrbtyhQjUhXh16j2G-fvCMZnRR-JhsBPPSzRY13VTNnVdrqg8oRTmGAN35hj8aMO9QTCbNtObTZvZtBlQZtW2hl4-9C_tyO5v5I-nFXhzAni98ofnYCJ5noidD0zJuNn_v__dP3Ea_OTJDt_4nmM_L2Fa_Rk0URown7bHbX_DSoFSUqvfTLuTaQ</recordid><startdate>20170801</startdate><enddate>20170801</enddate><creator>Woernley, Timothy C., D.D.S</creator><creator>Wright, Thomas L., D.M.D</creator><creator>Lam, Duc N., D.D.S</creator><creator>Jundt, Jonathon S., D.D.S., M.D</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20170801</creationdate><title>Oculocardiac Reflex in an Orbital Fracture without Entrapment</title><author>Woernley, Timothy C., D.D.S ; Wright, Thomas L., D.M.D ; Lam, Duc N., D.D.S ; Jundt, Jonathon S., D.D.S., M.D</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-e43cd49fecfeacbbff04e141751bade20d7ad042d80d5c2d4c9351b44f5417c03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2017</creationdate><topic>Adult</topic><topic>Dentistry</topic><topic>Eye Movements - physiology</topic><topic>Heart Rate - physiology</topic><topic>Humans</topic><topic>Imaging, Three-Dimensional</topic><topic>Male</topic><topic>Orbit - diagnostic imaging</topic><topic>Orbit - surgery</topic><topic>Orbital Fractures - diagnostic imaging</topic><topic>Orbital Fractures - physiopathology</topic><topic>Orbital Fractures - surgery</topic><topic>Reflex, Oculocardiac - physiology</topic><topic>Surgery</topic><topic>Tomography, X-Ray Computed</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Woernley, Timothy C., D.D.S</creatorcontrib><creatorcontrib>Wright, Thomas L., D.M.D</creatorcontrib><creatorcontrib>Lam, Duc N., D.D.S</creatorcontrib><creatorcontrib>Jundt, Jonathon S., D.D.S., M.D</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of oral and maxillofacial surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Woernley, Timothy C., D.D.S</au><au>Wright, Thomas L., D.M.D</au><au>Lam, Duc N., D.D.S</au><au>Jundt, Jonathon S., D.D.S., M.D</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Oculocardiac Reflex in an Orbital Fracture without Entrapment</atitle><jtitle>Journal of oral and maxillofacial surgery</jtitle><addtitle>J Oral Maxillofac Surg</addtitle><date>2017-08-01</date><risdate>2017</risdate><volume>75</volume><issue>8</issue><spage>1716</spage><epage>1721</epage><pages>1716-1721</pages><issn>0278-2391</issn><eissn>1531-5053</eissn><abstract>Abstract Large orbital fractures in older patients are infrequently associated with an exaggerated oculocardiac reflex. We present a patient in their 5th decade with a large right orbital floor and medial wall fracture without radiographic evidence of extraocular muscle compression or entrapment who experienced severe nausea and bradycardia with movement of his affected eye. The patient exhibited bradycardia to 17 beats per minute during the initial examination and was taken emergently to the OR for reconstruction of the right orbital floor and medial wall. Additional episodes of bradycardia intraoperatively were responsive to glycopyrrolate. After the procedure, the patient’s pain was reduced, a normal range of motion was restored, and the bradycardia and nausea resolved. An explanation for induction of the oculocardiac reflex is considered in the absence of clinical or radiological entrapment as large orbital fractures are not often considered to induce this reflex.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>28412263</pmid><doi>10.1016/j.joms.2017.03.014</doi><tpages>6</tpages></addata></record> |
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| ispartof | Journal of oral and maxillofacial surgery, 2017-08, Vol.75 (8), p.1716-1721 |
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| source | MEDLINE; Elsevier ScienceDirect Journals |
| subjects | Adult Dentistry Eye Movements - physiology Heart Rate - physiology Humans Imaging, Three-Dimensional Male Orbit - diagnostic imaging Orbit - surgery Orbital Fractures - diagnostic imaging Orbital Fractures - physiopathology Orbital Fractures - surgery Reflex, Oculocardiac - physiology Surgery Tomography, X-Ray Computed |
| title | Oculocardiac Reflex in an Orbital Fracture without Entrapment |
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