orbital floor fracture repair complications

Three patients developed unilateral proptosis 13 16 and 20 years after repair of blow-out fracture with orbital floor Teflon implants. Jordan DR Allen LH White J Harvey J Pashby R Esmaeli B.

Orbital Fracture Orbital Blow Out Orbital Trauma

A variety of applicable surgical techniques and technologies are available to surgeons so data about which of these may decrease postoperative complication rates can help better guide clinical decision making.

. Of all patients 392 remain with long term unresolved complications. As with any surgical procedure bleeding infection and the need for additional surgery are risks. 27 2017 HealthDay News For patients undergoing orbital floor fracture repair total operative time and postoperative complications are similar for cases performed by plastic surgeons versus ear nose and throat ENT surgeons according to a research letter published online Oct.

In one patient trauma preceded the onset of proptosis. Fractures of the orbital floor are commonly repaired by all specialists who manage facial trauma. There are numerous acute complications from orbital fracture repair which can include permanent loss of vision in the affected eye.

Bruising and limited eye movements secondary to swelling are common clinical presentations top. CAS Article Google Scholar. The floor fracture is no more than a decompression of the increased intra-orbital pressure due to the anterior shock during orbital trauma.

Altered vision is more probable with older patients and with longer surgeries. Intervention within days for some orbital floor fractures. Complications associated with alloplastic implants used in orbital floor fracture repair.

Depending on the amount and severity of dislocation around the course of the infraorbital nerve decompression might be indicated. The inferior rectus muscle or orbital tissue can become entrapped within the fracture. This energy results in pressure with a downward and medial vector usually targeting the infraorbital groove.

Orbital floor fracture repair is complex and postoperative complications are common. Pure orbital floor fractures referred to as isolated floor fractures result from impact injury to the globe and upper eyelid. Vision loss double vision globe malposition hypoesthesia and lid malposition.

The long term complications of orbital floor fracture repair and because for most cases outpatient follow-up seldom lasted more than five years usually about one year addi-tional information was gathered by a telephone survey. Potential complications include incomplete correction of preoperative enophthalmos or diplopia as well as induction of hypoglobus or hyperglobus eyelid malposition or optic nerve injury. 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.

Residual or new-onset diplopia neuralgia and extraocular muscle dysfunction are potential complications. Diplopia was least likely to occur with orbitozygomatic or panfacial fractures and more probable with bone grafts. In all three cases the cause of the proptosis was probably hemorrhage of the capillaries in a fibrous capsule that surrounded the implant and that was evident on orbital CT.

Oculoplastic surgeons deal with all the complications resulting from orbital fracture repair. All patients whose last chart review indicated ongoing complica-. Orbital floor fractures can increase volume of the orbit with resultant hypoglobus and enophthalmos.

The findings suggest that orbital floor fracture repair is. To optimize functional and aesthetic results a stepwise analysis of the. Repiratory epithelial ingrowth and hemorrhage as late complications of orbital floor fracture repair with silicone sheet implant.

26 in JAMA Facial Plastic Surgery. Residual or new-onset diplopia neuralgia and extraocular muscle dysfunction are potential complications. Fractures of the floor represent the most common type of orbital wall injury 11 12 and absolute indications for surgical repair include diplopia that fails to resolve after 24 weeks or dynamic muscle entrapmentMore commonly occurring relative indications for surgery include cosmetic considerations such as enophthalmos greater than 2 mm significant hypoglobus.

The possible loss of vision is the most ominous complication associated with floor repair. Some of these complications include the very things that surgery is intended to avoid. Orbital floor fractures are secondary to a sudden increase in intraorbital hydraulic pressure.

Ophthal Plast Reconstr Surg. An example of a patient presenting with a right orbital floor blowout fracture. Fractures of the orbital floor are commonly repaired by all specialists who manage facial trauma.

This hyper-pressure can lead to herniation of the orbital contents through the fracture with increased intra-orbital volume. As with any surgical procedure bleeding infection and the need for additional surgery are risks. The possible loss of vision is the most ominous complication associated with floor repair.

Postoperative complications did not differ significantly for patients undergoing repair by ENT or plastic surgeons. Reintervention resolved one of three complications. A high-velocity object that impacts the globe and upper eyelid transmits kinetic energy to the periocular structures.

Orbital floor fracture repair complications. Reconstruction of the orbital floor has to respect the course of the infraorbital nerve in the orbital floor. CT scan demonstrates common findings of a blow out fracture with.

So it gives us greater pause to do surgery without strong indications he said. Potential complications include incomplete correction of preoperative enophthalmos or diplopia as well as induction of hypoglobus or hyperglobus eyelid malposition or optic nerve injury. Early decompression is favorable for neural restitution.

Recognized sequelae of orbital floor fractures include enophthalmos diplopia from extraocular muscle dysfunction entrapment ischameia haemorrhage or nerve injury and infraorbital nerve.

Orbital Fracture Repair Abstract Europe Pmc