Orbital Roof Fracture Repair
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In addition to the formal ophthalmic exam a complete orbital exam is required.
Orbital roof fracture repair. When it comes to surgical repair of orbital floor fractures the consensus among oculoplastic specialists is that less is often more. Fixation of most materials in the orbital roof is achieved by the use of one or more screws. Fixation of orbital reconstruction material varies with the type and nature of the fracture. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof.
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. If significant globe trauma is identified i e. Ruptured globe or retinal detachment orbital surgery is usually postponed due to the increased risk this places on the damaged globe. The healing time of orbital fracture depends on the severity and location of the fracture.
Approaches include extracranial intracranial and endonasal endoscopic. However titanium meshes add to the cost of the surgery while bone graft requires additional graft donor site. 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. An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care.
Rates of open globe in with orbital roof fracture range from 4 9 5. However the fractured orbital bones take a longer time to heal. The diameter depends on anatomical requirements but will normally vary between 1 0 1 3 or 1 5 mm. Titanium meshes and bone grafts are radiopaque.
Repair of an orbital floor fracture involves bridging of the floor defect using one of the various biomaterials. The approach used is determined by the surgical needs of the patient. 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.
More commonly titanium meshes porous polyethylene sheets or autologous bone grafts. The orbital roofs were reconstructed using three dimensionally fabricated titanium micromesh plates and microscrews and the associated fractures were then repaired. Most can be safely observed.
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