A 30-Year-Old Man Comes to the Emergency Department Due to Left

question 131

Multiple Choice

A 30-year-old man comes to the emergency department due to left eye pain after being involved in a street fight.  He received a fist blow to the left eye and has since had pain and diplopia.  Past medical history is notable for 2 previous gunshot wounds.  The patient does not smoke cigarettes but has a history of heavy alcohol intake and frequent marijuana use.  On examination, there is significant soft tissue swelling around the left eye.  Visual acuity is normal, but extraocular motility of the left eye is limited.  Pupillary reflexes are normal.  Coronal CT scan of the orbits is shown in the image below. The orbital contents of this patient are most likely to herniate into which of the following sites?

• A)Ethmoid cells
• B)Frontal sinus
• C)Inferior conchae
• D)Maxillary sinus
• E)Sphenoid sinus

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Definitions:

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