PGCEE MDS 2022: The ‘hanging drop appearance’ in the maxillary sinus radiograph indicates:

 # The ‘hanging drop appearance’ in the maxillary sinus radiograph indicates:

a) A nasal polyp 

b) A blow out fracture of the orbit

c) A radiograph artifact 

d) An antrolith

The correct answer is B. A blow-out fracture of the orbit.

Orbital blow out fracture occurs when a rounded object struck the protruding eyeball resulting in a fracture of the orbital floor. "Blow in" fracture is due to inward buckling of the orbital floor. It usually occurs in children and results from trauma to the inferior orbital rim.

Hanging drop sign is best seen in the Water's projection of the face.

Characteristics of blow out fracture:

• Rupture of infraorbital plate and herniation of orbital contents into the maxillary antrum

• Fracture of the orbital floor into the maxillary antrum without the involvement of the orbital rim

• Restriction of lateral and upward movement of the eyeball

• Enophthalmos and profound diplopia

• Hanging drop appearance in the radiograph