Orbital Roof Fracture Repair

When the inner table of the orbital roof is not involved and there is no dural tear the orbital fracture can be accessed by superior orbitotomy.

Orbital roof fracture repair.

Titanium meshes and bone grafts are radiopaque. Most can be safely observed. Rates of open globe in with orbital roof fracture range from 4 9 5. If significant globe trauma is identified i e.

Ruptured globe or retinal detachment orbital surgery is usually postponed due to the increased risk this places on the damaged globe. An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. Many fractures of the orbit a common occurrence with facial trauma never require surgery which is customarily performed in patients with restricted motility diplopia and enophthalmos. Fixation of most materials in the orbital roof is achieved by the use of one or more screws.

Repair of an orbital floor fracture involves bridging of the floor defect using one of the various biomaterials. Approaches include extracranial intracranial and endonasal endoscopic. Alternatively matrix midface screws can be used. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof.

After neurologic repair the displaced orbital roof bone fragments were removed and optic nerve decompression was performed when a bone fragment compressed the optic nerve. The diameter depends on anatomical requirements but will normally vary between 1 0 1 3 or 1 5 mm. Fixation of orbital reconstruction material varies with the type and nature of the fracture. In majority of the cases of orbital fracture the discoloration and swelling begin to subside within a week to 10 days after the injury has occurred.

In addition to the formal ophthalmic exam a complete orbital exam is required. However the fractured orbital bones take a longer time to heal. The orbital roofs were reconstructed using three dimensionally fabricated titanium micromesh plates and microscrews and the associated fractures were then repaired. More commonly titanium meshes porous polyethylene sheets or autologous bone grafts.

Treating the fracture eye socket fractures don t always require surgery. Fracture to the orbital roof may require consultation with a neurologist or neurosurgeon. When it comes to surgical repair of orbital floor fractures the consensus among oculoplastic specialists is that less is often more.