Orbital Roof Fracture Repair

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.

Orbital roof fracture repair.

Fixation of orbital reconstruction material varies with the type and nature of the fracture. Rates of open globe in with orbital roof fracture range from 4 9 5. The diameter depends on anatomical requirements but will normally vary between 1 0 1 3 or 1 5 mm. However the fractured orbital bones take a longer time to heal.

Fracture to the orbital roof may require consultation with a neurologist or neurosurgeon. Titanium meshes and bone grafts are radiopaque. Alternatively matrix midface screws can be used. 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.

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. If significant globe trauma is identified i e. However titanium meshes add to the cost of the surgery while bone graft requires additional graft donor site. In addition to the formal ophthalmic exam a complete orbital exam is required.

Treating the fracture eye socket fractures don t always require surgery. Fixation of most materials in the orbital roof is achieved by the use of one or more screws. Approaches include extracranial intracranial and endonasal endoscopic. Repair of an orbital floor fracture involves bridging of the floor defect using one of the various biomaterials.

An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof. When it comes to surgical repair of orbital floor fractures the consensus among oculoplastic specialists is that less is often more. More commonly titanium meshes porous polyethylene sheets or autologous bone grafts.

The approach used is determined by the surgical needs of the patient. Most can be safely observed. 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.