Turbin et al studied penetrating transorbital injuries causing intracranial injury. They divided the orbit into 4 anatomic zones that correlate with the intracranial injury. The authors are from the University of Medicine and Dentistry and Hackensack University Medical Center in New Jersey.
Patient selection: penetrating injury, with a transorbital path into the intracranial space
|
Zone |
Description |
|
1 |
penetrating injury to the central or lateral upper eyelid and/or superior conjunctiva |
|
2 |
penetrating injury to the central or lateral lower eyelid and/or inferior conjunctiva |
|
3a |
penetrating injury to the upper third of the medial aspect; may involve the upper eyelid and/or superior conjunctiva |
|
3b |
penetrating injury to the middle third of the medial aspect; may involve the medial canthus |
|
3c |
penetrating injury to the lower third of the medial aspect; may involve the lower eyelide and/or inferior conjunctiva |
|
4 |
laceration(s) in Zones 1 and/or 2 |
|
Zone |
Path of Penetration |
|
1 |
orbital roof or sphenoid wing |
|
2 |
orbital roof, superior orbital fissure, inferior orbital fissure, orbital floor |
|
3a |
superior orbital fissure, orbital roof, optic canal, sphenoid wing |
|
3b |
superior orbital fissure, sphenoid wing |
|
3c |
superior orbital fissure, optic canal, sphenoid ring |
|
4 |
orbital roof, superior orbital fissure, sphenoid wing, orbital floor, inferior orbital fissure |
|
CNS Injuries |
Zones |
|
frontal lobe |
1, 2, 3a, 4 |
|
temporal lobe |
1, 2, 3a, 3b, 3c, 4 |
|
cavernous sinus |
2, 3a, 3b, 3c, 4 |
|
pterygopalatine/infratemporal fossa |
2, 4 |
|
brainstem |
3b, 3c |
|
basal cistern |
3a, 3b |
Specialty: Ophthalmology, Emergency Medicine, Surgery, general
ICD-10: ,
