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Orbital Fractures

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Atlas of Operative Maxillofacial Trauma Surgery

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Abstract

This highly illustrated chapter discusses the initial assessment, investigations and management of fractures of the orbit. Numerous case examples are shown, step-by step, illustrating the access and surgical repair of most fractures commonly seen. Technical advances and current areas of controversy are also discussed.

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Selected Reading

  • Appling WD, Patrinely JR, Salzer TA. Transconjunctival approach vs. subciliary skin-muscle flap approach for orbital fracture repair. Arch Otolaryngol. 1993;119:1000–7.

    Article  CAS  Google Scholar 

  • Buchel P, Rahal A, Seto I, Iizuka T. Reconstruction of orbital floor fracture with polyglactin 910/polydioxanon patch (Ethisorb): a retrospective study. J Oral Maxillofac Surg. 2005;63:646–50.

    Article  PubMed  Google Scholar 

  • Burm JS. Internal fixation in trapdoor-type orbital blowout fracture. Plast Reconstr Surg. 2005;116:962–70.

    Article  CAS  PubMed  Google Scholar 

  • Burm JS, Chung CH, Oh SJ. Pure orbital blowout fracture, new concepts and importance of medial orbital blowout fracture. Plast Reconstr Surg. 1999;103:1839–49.

    Article  CAS  PubMed  Google Scholar 

  • Burnstine MA. Clinical recommendations for repair of orbital facial fractures. Curr Opin Ophthalmol. 2003;14:236–40.

    Article  PubMed  Google Scholar 

  • Castellani A, Negrini S, Zanetti U. Treatment of orbital floor blowout fractures with conchal auricular cartilage graft: a report on 14 cases. J Oral Maxillofac Surg. 2002;60:1413–7.

    Article  PubMed  Google Scholar 

  • Chang EL, Bernardino CR. Update on orbital trauma. Curr Opin Ophthalmol. 2004;15:411–5.

    Article  PubMed  Google Scholar 

  • Cheong EC, Chen CT, Chen YR. Endoscopic management of orbital floor fractures. Facial Plast Surg. 2009;25:8–16.

    Article  CAS  PubMed  Google Scholar 

  • Converse JM, Firmin F, Wood-Smith D, Friedland JA. The conjunctival approach in orbital fractures. Plast Reconstr Surg. 1973;52:656–7.

    Article  CAS  PubMed  Google Scholar 

  • Cunningham LL, Peterson GP, Haug RH. The relationship between enophthalmos, linear displacement, and volume change in experimentally recreated orbital fractures. J Oral Maxillofac Surg. 2005;63:1169–73.

    Article  PubMed  Google Scholar 

  • Ellis III E, Tan Y. Assessment of internal orbital reconstructions for pure blowout fractures: cranial bone grafts versus titanium mesh. J Oral Maxillofac Surg. 2003;61:442–53.

    Article  PubMed  Google Scholar 

  • Evans BT, Mourouzis C. Lateral orbitotomy: a useful technique in the management of severe traumatic disruption of the lateral orbital skeleton. Int J Oral Maxillofac Surg. 2009;38:984–7.

    Article  CAS  PubMed  Google Scholar 

  • Forrest CR, Lata AC, Marcuzin DW, Bailey MH. The role of orbital ultrasound in the diagnosis of orbital fractures. Plast Reconstr Surg. 1993;92:28–34.

    Article  CAS  PubMed  Google Scholar 

  • Francis DO, Kaufman R, Yueh B, Mock C, Nathens AB. Air bag-induced orbital blow-out fractures. Laryngoscope. 2006;116:1966–72.

    Article  PubMed  Google Scholar 

  • Fujino T, Sugimoto C, Tajima S, Moribe Y, Sato TB. Mechanism of orbital blowout fracture: II. Analysis by high speed camera in two dimensional eye model. Keio J Med. 1974;23:115–24.

    Article  CAS  PubMed  Google Scholar 

  • Gellrich NC, Schramm A, Hammer B, Schmelzeisen R. The value of computer-aided planning and intraoperative navigation in orbital reconstruction. Int J Oral Maxillofac Surg. 1999;28 Suppl 1:52.

    Article  Google Scholar 

  • Goldberg RA, Garbutt M, Shorr N. Oculoplastic uses of cranial bone grafts. Ophthalmic Surg. 1993;24:190–6.

    CAS  PubMed  Google Scholar 

  • Habal MB. Bone grafting the orbital floor for posttraumatic defects. J Craniofac Surg. 1992;3:175–80.

    Article  CAS  PubMed  Google Scholar 

  • Hayter JP, Sugar AW. An orbital observation chart. Br J Oral Maxillofac Surg. 1991;29:77–9.

    Article  CAS  PubMed  Google Scholar 

  • He D, Blomquist PH, Ellis III E. Association between ocular injuries and internal orbital fractures. J Oral Maxillofac Surg. 2007;65:713–20.

    Article  PubMed  Google Scholar 

  • Hosal BM, Beatty RL. Diplopia and enophthalmos after surgical repair of blowout fracture. Orbit. 2012;21:27–33.

    Article  Google Scholar 

  • Hundepool AC, Willemsen MAP, Koudstaal MJ, van der Wal KG. Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis. Int J Oral Maxillofac Surg. 2012;41:489–93.

    Article  CAS  PubMed  Google Scholar 

  • Jank S, Emshoff R, Schuchter B, Strobl H, Brandlmaier I, Norer B. Orbital floor reconstruction with flexible Ethisorb patches: a retrospective long-term follow-up study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2003;95:16–22.

    Article  PubMed  Google Scholar 

  • Jank S, Emshoff R, Etzelsdorfer M, Strobl H, Nicasi A, Norer B. The diagnostic value of ultrasonography in the detection of orbital floor fractures with a curved array transducer. Int J Oral Maxillofac Surg. 2004;33:13–8.

    Article  CAS  PubMed  Google Scholar 

  • Jin HR, Yeon JY, Shin SO, Choi YS, Lee DW. Endoscopic versus external repair of orbital blowout fractures. Otolaryngol Head Neck Surg. 2007;136:38–44.

    Article  PubMed  Google Scholar 

  • Johnson PE, Raftopoulos I. In situ splitting of a rib graft for reconstruction of the orbital floor. Plast Reconstr Surg. 1999;103:1709–11.

    Article  CAS  PubMed  Google Scholar 

  • Kelly CP, Cohen AJ, Yavuzer R, Jackson IT. Cranial bone grafting for orbital reconstruction: is it still the best? J Craniofac Surg. 2005;16:181–5.

    Article  PubMed  Google Scholar 

  • Kontio R. Treatment of orbital fractures: the case for reconstruction with autogenous bone. J Oral Maxillofac Surg. 2004;7:863–8.

    Article  Google Scholar 

  • Kontio RK, Laine P, Salo A, Paukku P, Lindqvist C, Suuronen R. Reconstruction of internal orbital wall fracture with iliac crest free bone graft: clinical, computed tomography, and magnetic resonance imaging follow-up study. Plast Reconstr Surg. 2006;118:1365–75.

    Article  CAS  PubMed  Google Scholar 

  • Krishnan V, Johnson JV. Orbital floor reconstruction with autogenous mandibular symphyseal bone grafts. J Oral Maxillofac Surg. 1997;55:327–30.

    Article  CAS  PubMed  Google Scholar 

  • Lai A, Gliklich RE, Rubin PA. Repair of blow-out fractures with nasoseptal cartilage. Laryngoscope. 1998;5:645–50.

    Article  Google Scholar 

  • Lal D, Stankiewicz JA. Endoscopic optic nerve decompression. Oper Tech Otolaryngol. 2009;20:96–100.

    Article  Google Scholar 

  • Lee S, Maronian N, Most SP, Most SP, Whipple ME, McCulloch TM, et al. Porous high-density polyethylene for orbital reconstruction. Arch Otolaryngol Head Neck Surg. 2005;131:446–50.

    Article  PubMed  Google Scholar 

  • Manolidis S, Weeks BH, Kirby M, Scarlett M, Hollier L. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg. 2002;13:726–38.

    Article  CAS  PubMed  Google Scholar 

  • Mathog RH. Repair of orbital floor fractures with bioactive glass implants. J Oral Maxillofac Surg. 2001;59:1390–5.

    Article  Google Scholar 

  • Metzger MC, Schön R, Weyer N, Rafii A. Anatomical 3-dimensional pre-bent titanium implant for orbital floor fractures. Ophthalmology. 2006;113:1863–8.

    Article  PubMed  Google Scholar 

  • Nagasao T, Miyamoto J, Nagasao M, Ogata H, Kaneko T, Tamaki T, Nakajima T. The effect of striking angle on the buckling mechanism in blowout fracture. Plast Reconstr Surg. 2006;117:2373–80; discussion 2381.

    Article  CAS  PubMed  Google Scholar 

  • Nagasao T, Hikosaka M, Morotomi T, Nagasao M, Ogawa K, Nakajima T. Analysis of the orbital floor morphology. J Craniomaxillofac Surg. 2007;35:112–9.

    Article  PubMed  Google Scholar 

  • Nolasco FP, Mathog RH. Medial orbital wall fractures: classification and clinical profile. Otolaryngol Head Neck Surg. 1995;112:549–56.

    CAS  PubMed  Google Scholar 

  • O’Regan MB, Macleod SPR. Miniantrostomy for the reduction of fractures in the orbital floor. Br J Oral Maxillofac Surg. 2000;38:191–2.

    Article  PubMed  Google Scholar 

  • Parsons GS, Mathog RH. Orbital wall and volume relationships. Arch Otolaryngol Head Neck Surg. 1988;114:743–7.

    Article  CAS  PubMed  Google Scholar 

  • Patel PC, Sobota BT, Patel NM, Green JS, Millman B. Comparison of transconjunctival versus subciliary approaches for orbital fractures: a review of 60 cases. J Craniomaxillofac Trauma. 1998;4:17–21.

    CAS  PubMed  Google Scholar 

  • Persons BL, Wong GB. Transantral endoscopic orbital floor repair using resorbable plate. J Craniofac Surg. 2002;13:483–8.

    Article  PubMed  Google Scholar 

  • Potter JK, Ellis E. Biomaterials for reconstruction of the internal orbit. J Oral Maxillofac Surg. 2004;62:1280–97.

    Article  PubMed  Google Scholar 

  • Reymond J, Kwiatkowski J, Wysocki J. Clinical anatomy of the superior orbital fissure and the orbital apex. J Craniomaxillofac Surg. 2008;36:346–53.

    Article  PubMed  Google Scholar 

  • Rhee JS, Kilde J, Yoganadan N, Pintar F. Orbital blowout fractures: experimental evidence for the pure hydraulic theory. Arch Facial Plast Surg. 2002;4:98–101.

    Article  PubMed  Google Scholar 

  • Schön R, Metzger MC, Zizelmannn C, Weyer N, Schmelzeisen R. Individually preformed titanium mesh implants for true-to-original repair of orbital fractures. Int J Oral Maxillofac Surg. 2006;35:990–5.

    Article  PubMed  Google Scholar 

  • Tessier P. Inferior orbitotomy: a new approach to the orbital floor. Clin Plast Surg. 1982;9:569–75.

    CAS  PubMed  Google Scholar 

  • Warwar RE, Bullock JD, Ballal DR, Ballal RD. Mechanisms of orbital floor fractures: a clinical, experimental, and theoretical study. Ophthal Plast Reconstr Surg. 2000;16:188–200.

    Article  CAS  PubMed  Google Scholar 

  • Waterhouse N, Lyne J, Urdang M, Garey L. An investigation into the mechanism of orbital blowout fractures. Br J Plast Surg. 1999;52:607–12.

    Article  CAS  PubMed  Google Scholar 

  • Wilson S, Ellis III E. Surgical approaches to the infraorbital rim and orbital floor: the case for the subtarsal approach. J Oral Maxillofac Surg. 2006;64:104–7.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Craniofacial Trauma Unit, Barts Health NHS Trust, London, UK

    Simon Holmes (Consultant Maxillofacial Surgeon)

  2. Regional North West London Craniomaxillofacial unit, Northwick Park and St Mary’s Major trauma service, Northwick Park Hospital, Harrow, Middlesex, UK

    Michael Perry

  3. Craniofacial Trauma Unit, Barts Health NHS Trust, London, England, UK

    Joe McQuillan (Senior Orthoptist)

  4. Regional Eye Unit, Royal Victoria Hospital, Belfast, Northern Ireland, UK

    Steve White

Authors
  1. Simon Holmes
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  2. Michael Perry
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  3. Joe McQuillan
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  4. Steve White
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Corresponding author

Correspondence to Simon Holmes .

Editor information

Editors and Affiliations

  1. Regional North West London Craniomaxillofacial unit, Northwick Park and St Mary's Major trauma service, Northwick Park Hospital, Harrow, Middlesex, United Kingdom

    Michael Perry

  2. The Royal London Hospital, London, United Kingdom

    Simon Holmes

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Holmes, S., Perry, M., McQuillan, J., White, S. (2014). Orbital Fractures. In: Perry, M., Holmes, S. (eds) Atlas of Operative Maxillofacial Trauma Surgery. Springer, London. https://doi.org/10.1007/978-1-4471-2855-7_9

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  • DOI: https://doi.org/10.1007/978-1-4471-2855-7_9

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-2854-0

  • Online ISBN: 978-1-4471-2855-7

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