Abstract
Purpose: :
To evaluate the incidence of canalicular involving dog bite injuries. The majority of eyelid injuries do not involve the canaliculi. It has been our observation that periocular dog bite injuries involve the canaliculi more frequently than lacerations due to other mechanisms. To date reports of canalicular sparing periocular dog bites have been extremely limited.
Methods: :
In this retrospective case series, the records of all patients referred to the oculoplastics service at the Massachusetts Eye and Ear Infirmary with a diagnosis of dog bite between January 1994 and November 2005 were reviewed. Variables assessed included canalicular involvement, age, sex, associated injuries and surgical repair.
Results: :
A total of 37 patients who suffered periocular dog bites were identified. The lacrimal canaliculi were injured in 26 (70%) patients. Distribution of age and sex did not differ significantly between those with canalicular injuries and those with canalicular sparing injuries. The mean age at the time of injury was 13 years (range 1–52) in those patients with canalicular injuries and 24 years (3–68) in those with canalicular sparing lesions (p=0.17). Females accounted for 38% of patients with canalicular injuries and 37% of those with canalicular sparing injuries (p=0.90). Two patients had involvement of both the superior and inferior canaliculus of the affected eye. The inferior canaliculus was involved more frequently (20 injuries) than the superior canaliculus (8). Surgical repair was performed in all but one patient in whom the injury was minimal and did not involve the canaliculus. Canalicular repair was carried out with Crawford tubes in 14 patients, Mini Monoka stents in 11, and canalicular marsupialization in 1.
Conclusions: :
Periocular dog bites have a propensity for involving the lacrimal canaliculus. We present the largest series to date of periocular dog bite injuries including the largest series of canalicular sparing dog bite injuries. The index of suspicion for canalicular lacerations should be raised when evaluating patients with dog bite related injuries.
Keywords: eyelid • trauma • clinical (human) or epidemiologic studies: prevalence/incidence