Orbital Roof Fracture Management

Mazzoli highlighted this contingency in children because roof fractures are much more common for them than for adults.

Orbital roof fracture management.

Management of orbital roof fractures varies based on individual clinical features including the presence of exophthalmos gaze restriction and concomitant injuries such as dural tears. Even in the context of floor fractures dr. Surgically bicoronal approaches were performed most commonly along with reconstruction utilizing titanium miniplates. Another potential emergency involves the roof not the floor of the orbit.

That s because they go headfirst over handlebars and tend to do a forehead plant. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof. An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. Approaches include extracranial intracranial and endonasal endoscopic.

Investigation of orbital fractures is by x ray and ct with ct being the modality of choice though it can be unreliable in children with blowout fractures. In cases of minor isolated orbital roof fractures where no surgical intervention is needed the patient. Most can be safely observed. The approach used is determined by the surgical needs of the patient.

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. Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases.