<prompt> Tear-drop appearance on PNS x-ray is seen in?Fracture of medial wall of the orbitFracture of maxillary sinusFracture of ethmoidal sinusFracture floor of the orbit  <response>: Ans. D. Fracture floor of the orbit1. Orbital fracture is commonly seen in patients with direct blunt injury to the maxillofacial area.2. Blunt trauma to the orbit results in in-drawing of the globe causing an abrupt increase in the intra-orbital pressure.3. The outcome is burst fractures of the orbital walls, most commonly the orbital floor and medial orbital wall lamina papyracea - On plain radiography, orbital fractures may be difficult to detect due to overlapping bony structures.4. Signs that may help to identify orbital trauma include:a. Orbital emphysemab. Air-fluid level within adjacent maxillary sinusc. Soft tissue with a tear-drop appearance projected over roof of maxillary sinus5. The exact anatomical extent, complexity of orbital fractures and trauma to other structures such as the lens is better appreciated by CT. 