orbital floor fracture repair

Figure 1 Preoperative coronal A and sagittal B computed tomography of the head with the bone algorithm showing a comminuted blowout fracture involving the right orbital floor that approximately measures 086 cm 15 cm 1 cm in maximum orthogonal dimensions which was associated with fat herniation inferior rectus muscle entrapment soft tissue swelling and. More commonly titanium meshes porous polyethylene sheets or autologous bone grafts.

Orbital Fracture Repair Plastic Surgery Key

Therefore this study investigated the outcomes of implant surgery for inferior orbital wall fractures by comparing three groups according to the time interval between the injury and surgery.

. Repair is typically. Orbital fracture is a breakage in the bone in the eye socket which can involve the rim the floor or even both. Diplopia within 30 of primary gaze associated with a positive forced duction test clinically significant enophthalmos greater than 2 mm and a fracture size greater than 50 of the orbital floor.

Oculocardiac reflex bradycardia and nausea from traction on orbital contents with significant herniation of orbital contents. Reconstruction of the orbital floor has to respect the course of the infraorbital nerve in the orbital floor. Some orbital floor fractures may be minor and not require operative treatment.

Postoperative instructions following Orbital Fracture Repair Surgery. Nonresolving oculocardiac reflex the white-eyed blowout fracture and early enophthalmos or hypoglobus are indications for immediate surgical repair. Here is a case study from one of his patients.

Some orbital floor fractures may be minor and not require operative treatment. Treatment for Orbital Fracture comprises of surgery in severe cases and ice packs rest and antibiotics in mild fractures. Orbital floor fracture repair might be indicated in this setting for small or medium sized defects.

Therefore some irritation and foreign body sensation in the eye is normal. The CT scan shows a significant orbital. An incision was made in the inside of the eyelid during surgery.

Khalifehs preferred approach for fixing orbital floor defects is the transconjunctival approach. However titanium meshes add to the cost of the surgery while bone graft requires additional graft donor site. Repair of an orbital floor fracture involves bridging of the floor defect using one of the various biomaterials.

Notice significant enophthalmos recession of the right eyeball into the maxillary sinus in this young woman who came to the emergency room after a fall. The time to treatment. Other indications vary but most surgeons will repair fractures within 2 weeks if one or more of the following criteria are met.

Timing of orbital floor fracture repair surgery is critical as orbital and cheekbone fractures may heal quickly. Depending on the amount and severity of dislocation around the course of the infraorbital nerve decompression might be indicated. Early decompression is favorable for neural restitution.

Orbital floor fracture repair surgery is most frequently performed with an open technique in which skin incisions are necessary. A lateral canthotomy is then performed with a 15 blade followed by an inferior cantholysis. Orbital floor fracture repair surgery is most frequently performed with an open technique in which skin incisions or incisions within the lining of the eyelid are necessary.

The only truly modifiable variable was the material used for orbital floor repair. The timing and treatment indications for orbital floor fractures are evolving. Timing of orbital floor fracture repair surgery is critical as orbital and cheekbone fractures may heal quickly.

This video demonstrates repair of a left orbital floor fracture. Illustration depicting the left bony orbit. Orbital Floor Fractures Section V.

I have started to worry about my eye and would like to know what my treatment options are for an orbital wall fracture. To help this and decrease scarring on the inside of the eyelid ointment andor drops MUST be put in the eye 4 times a day until seen in clinic for the post-operative visit. A retrospective review was conducted of patients medical charts and initial computed tomography images from 2009 to 2020.

Orbital floor fracture repair should restore orbital volume by replacing orbital tissues to their anatomical position within the orbit and reconstructing the orbital bony anatomy. Alloplastic prostheses should be used but if large or comminuted fractures are involved bone grafting is an interesting first choice. A frequently cited study by Dal Canto and Linberg 2 demonstrated that patients fared equally well if their orbital floor fractures were repaired within 14 days or within 29 days after trauma.

40 silk sutures are placed through the lower eyelid at the level of the tarsus. Fractures involving the orbit most commonly affect the. Orbital Implants Orbital Implants Autogenous grafts Bone Cartilage Human donor grafts Xenografts Alloplastic implants Porous polyethylene Porous polyethylenetitanium Titanium mesh Polyamide mesh Benefits of alloplastic implants Sizeable to accommodate defect.

This video illustrates the use of porous polyethylene implant stabilized with cyanoacrylate glue to repair an orbital floor fracture by the transconjunctival. In this retrospective study of 58 patients 36 eyes repaired within 14 days mean of 9 days were compared with 22 eyes repaired at up to 29 days mean of 19 days. Surgery within 2 weeks is recommended in cases of symptomatic diplop.

Can be without clinical evidence of extraocular muscle entrapment OPRS 2009. The circular orbit is divided into four walls. Any entrapped orbital tissues should be freed from the fracture site at the time of surgery releasing any mechanical strabismus which should be verified at the end of surgery with forced.

Titanium meshes and bone grafts are radiopaque. Forced ductions are checked which are shown to be restricted in supraduction. Appropriate timing is based on the clinical exam and imaging.

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