Nineteen patients operated on suspicion of bilateral orbital floor fractures are described. All of the patients had severe comminute midfacial fractures. Orbital floor deficiency requiring transplantation was found in 68% of the cases, demonstrating homolateral maxillary and zygomatic fractures. On the basis of their findings, the authors recommend acute reposition of the fractures and routine exploration of the orbital floor in the case of deficiencies requiring transplantation and in cases of homolateral combined maxillary and zygomatic fractures.

Ninety patients operated on, on suspicion of unilateral orbital floor fractures are described. Age, sex, and etiology are given. Operative indication is examined and related to the operative findings. Fifty-six of the patients had fractures requiring transplantation, 24 had fractures which did not. Ten patients had no fractures. Only autogenous bone graft was used. The patients were examined three months and one to 11 years postoperatively (questionnaire). Of 82 operated patients who answered the questionnaire diplopia was found in eight, enophthalmos in two, hypesthesia in 18, reduced mobility in four and sinuitis in four. Preoperative X-ray: Three patients showed false positive X-ray findings. In 19 patients with false negative X-ray findings 12 required transplantation. Twenty-five tomographed patients showed fractures, two of which proved to be false positives. In eight patients with negative tomographical findings, fractures were found, seven of which required transplantation. The frequency of complications assessed in relation to the time of operation shows no significant difference, if surgery takes place within seven days of injury. Surgery performed later than this seems to produce more cases of chronic sinuitis.

Five children earlier treated for capillary hemangiomas of the eyelid and orbit have been examined for cosmetic and functional results of treatment as well as their ocular status. In all cases the optic axis has been obstructed for a varying period in the first year of life. Two patients got exceedingly amblyopic and 3 patients moderately amblyopic. The cosmetic result is satisfactory in three cases. Different treatments have been used in these cases, i.e. surgical, X-ray and corticosteroid. The most essential aspect of the treatment is to open the eyeslit so much that the optic axis is free and in this way try to prevent amblyopia.

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Transcervical thymectomy was performed during a 13-year period in 21 patients with nonthymomatous myasthenia gravis. Follow-up showed that only eight patients benefited from the operation. These eight were among the younger patients in the series. This observation is discussed, and also the theoretic background for early thymectomy. The transsternal approach is recommended for thymectomy in elderly patients, but the transcervical may be considered for younger patients, although transsternal reexploration is advocated if this first operation should fail.