Blow-out fractures: Patterns of ocular motility and effect of surgical repair

Orbital Trauma: Keep an Eye for the Details!

“…The consequences of orbital floor fractures include enophthalmos, diplopia, limitation of ocular movement and altered sensation in the distribution area of infraorbital nerve. 2,3,7,10,11 Current management of orbital blowout fractures has become more standardized over the past few years, but treatment remains individualized. 2 The ideal technique, reconstructive material, various surgical approaches and the time of intervention could be influenced by many factors including the type of maxillofacial trauma and the experience of the surgeons.…”

Management of persistent diplopia after surgical repair of orbital fractures

“…The types of ocular motility patterns were distinguished by analyzing three main factors: Hess chart, field and character of diplopia, and passive duction/active force generation test. Patients were followed for a mean period of 10.5 months (range, [6][7][8][9][10][11][12].…”

“…Despite recent advances, such as individually shaped titanium mesh implants, 6 diplopia continues to affect 37% to 52% of patients after orbital reconstruction. [8][9][10] The direct cause of double vision in such patients is sometimes difficult to pinpoint. After extensive preparation inside the orbit, adherence syndrome may occur 11 ; the trauma itself may create a flap tear of the muscle belly 12 ; and surgical maneuvers may damage extraocular muscles.…”

The significance of orbital floor exploration during open reduction of zygomaticomaxillary complex fractures

“…Despite the multiple sophisticated imaging modalities and meticulous clinical examination, orbital floor defects associated with ZMC fractures may evade diagnosis and appropriate management. Moreover, it should be pointed out that the orbital floor is not routinely explored during open reduction of ZMC fractures; thus, orbital floor defects may remain undiagnosed and untreated even in cases of openly reduced ZMC fractures 5,12,13 . Undiagnosed, untreated or even mistreated orbital floor defects may result in considerable morbidity, impairing the patient's professional and social activity.…”