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Had metal plate and screws inserted in orbital floor after fracture. Ultra sound confirms nose septum deviated. What to do?

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General & Family Physician
Practicing since : 2009
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20 years ago I had a metal plate and screws inserted in left orbital floor after fracture now left eye is starting to turn upward and site very tender ultra sound confirms the nose septum is deviated towards the left with mucosal thickening in both maxillar sinuses there is mucossal thickening in ethmoidal sinuses bilaterally as well as right sphenoidal sinuses . Left eye is now more forward than the right and beggining to face upward. My email is YYYY@YYYY thank you your assistance XXXXX
Posted Mon, 23 Sep 2013 in Bones, Muscles and Joints
Answered by Dr. Chobufo Ditah 1 hour later
Brief Answer:
Could be an infection, get consulted urgently.

Detailed Answer:
Hi and thank you so much for this query.

I am so sorry to hear about this recent disturbing symptoms and findings you report. I do hope we would be able to identify the problem quickly and suggest solutions to you.

From the information you have provided, I am very much concerned that you could be having an infection. This is supported by the presence of a foreign body(which favors infections), tenderness, protruding eye, thickened mucosae of the various sinuses, etc. I suspect there could be an ongoing collection behind the left eye that is causing it to protrude and face upward.

I will suggest that you follow up urgently with your doctor. He would most likely need a CT scan of the head(sinuses) to clearly map out what the abnormality is so as to come up with a better plan. If my suspicion is confirmed, then you would need both surgery, blood cultures, antibiotics and pain medications to get this condition controlled. If the metal plate is found to be infected or contributing to the spread of this infection, it would most likely need to be removed. For this, you would need the coordinated services of a maxillo-facial surgeon, ophthalmologist and an infectiologist.

For the meantime, you may want to try so e pain medications for relief but the best thing is an urgent consultation.

I hope this addresses your query fully. Feel free to come back with follow up questions for clarifications if need be and I would gladly address them. I wish you a speedy recovery. Once more, thank you for this opportunity to respond to your health query today.
Dr. Ditah, MD

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