Pediatric Post-traumatic Orbital Subperiosteal Hematoma: A Case Series and Review of Literature

Purpose: To report a case series of five children presenting with post-traumatic subperiosteal hematoma and review the literature. Methods: In this study, we described five cases with post-traumatic subperiosteal hematoma in children retrospectively, and reviewed the similar cases in a systematic literature review. Results: Considering literature review, we included 39 cases in total. The mean age of the patients was 11.31 ± 3.41, ranging from 4 to 17 years and 79.5% of them pertained to boys. 36 patients (92.31 %) had a history of blunt trauma, falling and direct impaction and the other remaining patients had a history of car accident. 3 patients (7.69 %) had bilateral involvement. The Mean interval time between trauma and presentations was about 10 days. 10 patients (25.6 %) developed compressive traumatic optic neuropathy. Although, final visual acuity was impaired only in 3 of them. Nearly all of the patients had a subperiosteal hematoma in the superior orbital wall. Treatment options mostly included needle aspiration (28.21 %), surgical drainage (53.85 %) and observation for spontaneous resolution in 8 children (20.51 %). Conclusion: The most popular location for post-traumatic orbital subperiosteal hematoma is the superior orbital wall. Traumatic optic neuropathy and permanent visual loss is uncommon. Observation, surgical drainage and aspiration are common treatment options; however, surgical intervention is more often required