Clinical recommendations for repair of orbital facial fractures

• Published in: Current opinion in ophthalmology Vol. 14; no. 5; pp. 236 - 240
• Main Author: Burnstine, Michael A
• Format: Journal Article
• Language: English
• Published: United States Lippincott Williams & Wilkins, Inc 01-10-2003
• Subjects: Facial Bones - injuries; Fractures, Bone - therapy; Humans; Orbital Fractures - therapy
• ISSN: 1040-8738; 1531-7021
• DOI: 10.1097/00055735-200310000-00002

PURPOSE OF REVIEWOrbital facial fractures are a common result of facial trauma. Enophthalmos, diplopia resulting from extraocular muscle dysfunction, and infraorbital nerve hypesthesia may occur. The indications and timing for fracture repair are debated.
RECENT FINDINGSThe timing and treatment indications for orbital facial fractures are evolving. For orbital floor fractures, nonresolving oculocardiac reflex, the “white-eyed” blowout fracture, and early enophthalmos or hypoglobus are indications for immediate surgical repair. Surgery within 2 weeks is recommended in cases of symptomatic diplopia with positive forced ductions and evidence of orbital soft tissue entrapment on computed tomography examination or large orbital floor fractures, which may cause latent enophthalmos or hypo-ophthalmos. For midfacial, lateral, supraorbital, medial wall, and nasoethmoidal fractures, repair within 2 weeks is indicated to avoid difficult repair from immediate posttraumatic wound healing.
SUMMARYOrbital facial fracture management is germane to ophthalmologists, plastic surgeons, otolaryngologists, and others who treat patients.