Background:Orbital fractures are classified as diseases usually related to common midface trauma. It represents the most challenging treatment due to the complex anatomy, physiology, and aesthetic role. A midface trauma involves also the zygomatic complex and the nose, however the orbit fracture seems to be a more frequent disease due to its anatomical features.Objective:The purpose of this work is to retrospectively evaluate and record the frequency of the midfacial traumas and orbital fractures observed in the North Eastern Sicily. The results of the present data may be useful for the clinicians in order to recognize the kind of fracture just from the first general visit having a quick diagnosis and management.Methods:In the years between 2001 and 2016, about 1200 patients with midfacial trauma and about 100 patients involving the orbital floor have been evaluated. All those patients underwent the surgical fracture reduction and a CT scan follow up control at one month, three months, six months and one year.Results:Data showed high percentage of orbital floor, nose and mandibular body and ramus fractures; moreover the most frequent causes of fractures seem to be related to motor vehicle accident, followed by assaults, work and fall.Conclusion:The results have highlighted the changing trends in the causes of facial injuries, particularly the increasing incidence of assaults and the falling incidence of motor vehicle accidents in developed countries. The quick diagnosis and management proved fundamental for the successful treatment. Clinicians should be able to recognize the first symptoms in order to avoid possible complications.

Nowadays the development of diagnostic imaging, surgical techniques, alloplastic materials, and surgical instruments has made possible a more accurate management of orbital fractures. The aim of the present study was the management of orbital fractures and the solution of particular cases. The use of high-resolution computed tomography makes possible to gain a better understanding of the complex orbit anatomical structure. Also endoscopy is a valid alternative for medial orbital wall fractures treatment. It gives high control of the fracture site and its reduction. When this technology is combined with 3-dimensional (3D) reformatted images, it allows us to reconstruct more accurately the orbital defects. The authors present their experience in complex orbital fractures treated with the aim of the 3D navigation using a preformed orbital titanium plate. Endosopical approach was used to control plate positioning.

Traumatic, neoplastic, inflammatory, or infective dental removal promotes a gradual resorption process of bone which leads to a “nonuse” atrophy of the alveolar ridges. Many techniques allows restoring an appropriate bone thickness, but nowadays the attention is focused on the use of natural or synthetic grafts. Numerous studies have been conducted to develop and test new synthetic materials. In this article, the authors report their experience using a synthetic bone substitute in combination with Platelet Rich Fibrin (PRF). This technique was applied in different zones of the maxillomandibular district. The procedure showed a very satisfying bone regeneration without important complications.

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Background and Objective: Orbital blow-out fractures are commonly a result of motor vehicle accidents, interpersonal violence, or sports injuries and often require reconstructive surgery. A plethora of different surgical approaches are currently used in orbital floor reduction. These include transconjunctival, subciliary, mid-lower eyelid, infraorbital and, more recently, endoscopic transantral approaches. Some of the aforementioned treatment strategies are combined with additional measures like intraoperative imaging or navigation to enhance the accuracy hence surgical outcome. The current treatment method at the VU University Medical Center consists of a combination of virtual preoperative planning and three-dimensional (3D) printing. This novel approach has resulted in very good "subjective" clinical outcomes. However, an "objective" method of assessing the outcome of orbital reconstructions after trauma is still sought. Methods: To date, 15 patients have been operated using the aforementioned method. In order to assess the overall accuracy and the outcome of the orbital floor operation, virtually planned STL models were compared with the postoperative STL models of three patients. This presentation will describe all steps required to objectively assess the outcome of orbital reconstruction after trauma. Findings: The proposed 3D method demonstrated a strong agreement between the virtually planned and the resulting orbital floor reduction. This novel strategy offers a possible alternative to intraoperative CT and navigation in the treatment of orbital floor patients. Conclusions: Pre-and postoperative STL models can be used to evaluate the accuracy of orbital floor reconstructions after trauma. http://dx.

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