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.

Fixation of orbital reconstruction material varies with the type and nature of the fracture. If significant globe trauma is identified i e. The diameter depends on anatomical requirements but will normally vary between 1 0 1 3 or 1 5 mm. The orbital roofs were reconstructed using three dimensionally fabricated titanium micromesh plates and microscrews and the associated fractures were then repaired.

Rates of open globe in with orbital roof fracture range from 4 9 5. The approach used is determined by the surgical needs of the patient. An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. 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. Fracture to the orbital roof may require consultation with a neurologist or neurosurgeon. However the fractured orbital bones take a longer time to heal. 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.

Treating the fracture eye socket fractures don t always require surgery. More commonly titanium meshes porous polyethylene sheets or autologous bone grafts. Fixation of most materials in the orbital roof is achieved by the use of one or more screws. Titanium meshes and bone grafts are radiopaque.

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. However titanium meshes add to the cost of the surgery while bone graft requires additional graft donor site. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof. Ruptured globe or retinal detachment orbital surgery is usually postponed due to the increased risk this places on the damaged globe.

When it comes to surgical repair of orbital floor fractures the consensus among oculoplastic specialists is that less is often more. Most can be safely observed. In addition to the formal ophthalmic exam a complete orbital exam is required.