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Will Massa race again?

NEWS STORY
28/07/2009

Back in 1999, when Michael Schumacher was injured in a first lap accident during the British Grand Prix, and several times since, Dr Iain Corness - aka Pitpass' Medical Delegate - has given his invaluable medical opinion, more often than not proving to be 100% correct.

In the wake of Felipe Massa's accident at the Hungaroring, and in light of some of the more sensational reportage, The Doc has come up with the following, though he is at pains to point out that he is not a Neurosurgeon or an Ophthalmologist. Furthermore, it must be made clear that he has not examined Felipe, nor is he privy to the scans that have been taken, or the operation notes.

With this in mind, Iain writes:

As the world has been made very aware, Felipe Massa suffered a head injury during Qualifying at the Hungaroring on Saturday. The injury came from what we call "blunt trauma" to the left side of his forehead, just above his eye.

As I write this, the doctors in Hungary are being cautiously optimistic as regards the contusion to the brain, but are also saying that it is too early to tell the degree of possible damage to his left eye.

I am not a Neurosurgeon, nor am I an Ophthalmologist, but I was a Medical Assessor for the Confederation of Australian Motor Sports (CAMS) for 25 years, and from that point of view, the main problem for Massa in returning to F1, as I see it, is going to be a vision situation.

Blunt trauma to the forehead, enough to fracture the skull and produce brain concussion will most likely have fractured the orbit, in which the eye sits, with the optic nerve going through the rear of the orbit to the brain proper. The orbit is like an eggshell and is made up of seven facial bones, with the frontal bone, being the top of the orbit margin, and trauma transmitted to it may produce other orbit fractures. The fractured bone(s) and swelling after trauma can damage the optic nerve and alter the position of the globe of the eye within the cup-like orbit, or trap the muscles which move the eye in various directions. (Sorry to be a little technical here, but it is necessary that you understand the anatomy.)

Forgetting the brain concussion for now (from which he most likely will recover, though in a best-case scenario that will be measured in months, not weeks), damage to the orbit/optic nerve will be at least a few months before the swelling settles, even if the anatomy is not disturbed and damage to the optic nerve is bruising only. The likelihood of greater damage is high.

The principal morbidity associated with orbital fractures is eye injury. Associated injuries include corneal abrasion, lens dislocation, iris disruption, choroid tear, scleral tear, ciliary body tear or bruise, retinal detachment and tear, hyphema, ocular muscle entrapment, and globe rupture.

Any of the conditions listed above can cause vision problems, and an F1 competitor needs two good eyes which work together. Consequently, I would not expect Felipe Massa to be back in the cockpit this year, and indeed I would go so far as to suggest this may be the end of his racing career. I hope not, but it would not surprise.

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