orbital floor fracture complications
To optimize functional and aesthetic results a stepwise analysis of the surgical procedure is. Orbital floor fracture repair might be indicated in this setting for small or medium sized defects.
Orbits Skull Lateral Wall Medial Wall Floor Roof Lacrimal Bone Sphenoid Bone Paranasal Sinuses Body
Potential complications include incomplete correction of preoperative enophthalmos or diplopia as well as induction of hypoglobus or hyperglobus eyelid malposition or optic nerve injury.
. From the present retrospective review the complication rate following orbital floor fracture repair under regional anesthesia with conscious sedation when necessary is comparable to the result obtained under general anesthesia in our Level I Trauma Center and in the literature. For orbital floor reconstruction polydioxanone sheets 705 were mainly used followed by Ethisorb Dura 233 and titanium mesh 62. Large fracture 50 of orbital floor on CT scan indicates that enophthalmos is likely to occur.
Extraocular muscle entrapment from orbital floor fracture in a child. 135717182023 However the decreased reoperative rate for. So it gives us greater pause to do surgery without strong indications he said.
There are numerous acute complications from orbital fracture repair which can include permanent loss of vision in the affected eye. Surgery may be required in some patients to drain orbital abscess or to drain the paranasal sinuses in non-resolving cellulitis. In chronological order the following complications may occurafter orbital floor fracture repair.
Orbital floor fractures are a common result of orbital injury. Vision loss double vision globe malposition hypoesthesia and lid malposition. 58 suffered from persisting motility impairment 37 from enophthalmos 32 from consistent diplopia 26 from ectropion and 05 from orbital.
Indirect orbital fractures will only need surgery if another part of the eye has become trapped in the break or if more than 50 of the floor is. Some of these complications include the very things that surgery is intended to avoid. Fractures of the orbital floor are commonly repaired by all specialists who manage facial trauma.
An example of a patient presenting with a right orbital floor blowout fracture. Trigeminal function assessment. Concomitant medial orbital wall fracture can increase risk of progressive enophthalmos.
Children are more likely to have isolated linear fractures of the orbital roof similar to the greenstick fractures seen in the orbital floor. Bone grafts were chosen for large defects comminuted fractures or if other reconstruction eg sinus was required. Surface area of fracture 2 cm 5 25-50 involvement of inferior or medial orbital walls collapse of internal orbital buttress or convex junctional bulge internal orbital buttress located at the union between medial and inferior orbital walls.
Orbital floor fracture symptoms After facial trauma patients may describe decreased visual acuity blepharoptosis binocular vertical or oblique diplopia especially in upgaze and ipsilateral hypesthesia dysesthesia or hyperalgesia in the distribution of the infraorbital nerve. Dysesthesia diplopia ec-tropion and epiphora pain and stiffness enophthalmos infec-tion vision changes and extrusion. Common complications are postoperative edema chemosis ecchymoses blurry vision discomfort and tenderness.
Appropriate timing is based on the clinical exam and imaging. A retrospective comparative case series of all orbital floor fracture repair cases 158 eyes from 1983 to 1998 was done. Orbital floor fractures can increase volume of the orbit with resultant hypoglobus and enophthalmos.
CT scan demonstrates common findings of a blow out fracture with. Oculoplastic surgeons deal with all the complications resulting from orbital fracture repair. Tenderness or step-offs at the infraorbital rim Subcutaneous emphysema indicates a fracture of the maxillary sinus.
Some associa-tions that were made in the present study are. Bruising and limited eye movements secondary to swelling are common clinical presentations top. Late complication of orbital floor fracture repair with implant.
Synthetic prostheses were tailored to the orbital floor in clinically significant fractures. Orbital Floor Fractures Table of contents Table of contents Orbital Anatomy Clinical Presentation Indications for Surgical Repair. Complication of the surgery are directly related to the severity of the orbital fracture.
17 rows orbital cellulitis. Oral antibiotic therapy may be considered. There were 190 of patients who showed postoperative complications.
Visual loss with acute orbital emphysema has been reported. Complications 15-16 Technique guide. Long term unresolvedcomplications were suffered by 392 of eyes.
Orbital cellulitis is a rare but serious complication of. Decreased sensation over the inferior orbital rim extending to the edge of the nose and ipsilateral upper lip can occur. Prolapse of orbital fat Several imaging features are associated with late enophthalmos 1.
This is indicated by inability to move the eye in upward gaze or sometimes downward gaze and one may observe autonomic instability the oculocardiac reflex. Orbital Floor Fractures Technique Guide Editor. Orbital cellulitis is a rare but serious complication of orbital fractures.
Fractures that involve the medial wall and floor may be considered open fractures as. The inferior rectus muscle or orbital tissue can become entrapped within the fracture resulting. Routine antibiotic prophylaxis has not been proven to prevent orbital cellulitis or abscess formation.
Recognized sequelae of orbital floor fractures include enophthalmos diplopia from. Intraoperative bleeding excessive dissection of the orbit posteriorly or deep insertion of the implant can cause impingement on the orbital apex or retrobulbar hematoma possibly resulting in vision loss. The infraorbital nerve runs along the floor of the orbit.
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