Orbital Roof Fracture Management

Ophthal plast reconstr surg.

Orbital roof fracture management.

Orbital roof fractures are more common in childhood as the frontal sinus has not yet pneumatised therefore all posterior force to the superior orbital rim is transferred to the anterior cranial base. Fractures may only involve the sinus the anterior cranial fossa less common or both sinus and anterior cranial fossa. Orbital fractures are more common in males than in females and most often occur in men ages 21 to 30 years of age. Isolated non displaced orbital roof fractures most commonly seen in children and rarely require surgical intervention.

Most can be safely observed. Even in the context of floor fractures dr. 1 2 3 4 5 because frontal and paranasal sinuses prevent direct. Orbital roof fractures are relatively uncommon with singleinstitution estimates ranging from 1 to 9 of facial fractures.

Fractures of the orbital floor and the medial orbital wall are the most common fractured site. Goldberg ra steinsapir kd. Pure superior blowout fractures without associated orbital rim fracture are uncommon. They are usually seen in patients with pneumatization of the orbital roof 1 5.

An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall typically resulting from impact of a blunt object larger than the orbital aperture or eye socket most commonly the inferior orbital wall i e. Ophthal plast reconstr surg. Orbital roof fractures in childhood. Another mechanism of injury is a blow in fracture where there is an inferiorly directed supraorbital force.

An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. Orbital roof fractures are frequently associated with a high energy impact to the craniofacial region and displaced orbital roof fractures can cause ophthalmic and neurologic complications and occasionally require open surgical intervention. Management of ophthalmic complications. That s because they go headfirst over handlebars and tend to do a forehead plant.

The floor is likely to collapse because the bones of the roof and lateral walls are robust. However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof. Falls motor vehicle accidents and assaults account for most midfacial fractures. Extracranial optic canal decompression.

Fractures of the roof of the orbit are typically associated with trauma to the forehead frontal bone are are often extensions of superior orbital rim fractures.