Contemporary management of orbital blowout fractures

Abstract

Purpose of review Orbital floor blowout fractures may lead to significant morbidity, including debilitating double vision and globe malposition. Thorough evaluation and timely surgical intervention may prevent long-term sequelae. Recent findings New studies have demonstrated certain patients with orbital floor fractures to do well when managed conservatively. In those necessitating operative repair, precise surgical dissection and adequate fracture reduction are essential to restoring orbital anatomy and function. Novel surgical techniques and orbital floor reconstruction materials, described in this review, will further optimize patient outcomes. Summary A knowledgeable evaluation, thoughtful management strategy and modernized surgical technique can prevent long-term disability in patients with orbital floor blowout fractures.

Fractures du plancher de l’orbite

“…Les patients signalent habituellement des changements importants de l’acuité visuelle (p. ex., vision trouble monoculaire ou diplopie binoculaire), et de la douleur associée aux mouvements oculaires 2 . On devrait donc procéder à l’examen macroscopique de l’intégrité du globe oculaire, de l’acuité visuelle (application électronique ou échelle sur format papier) et des mouvements oculaires dans toutes les directions du regard.…”

“…Les patients devraient éviter de se moucher avec force pendant 4–6 semaines pour éviter le pneumorbite 2 . Un traitement oral de 7 jours à la prednisone (1 mg/kg pour 7 jours, puis sevrage sur 4 jours), accompagné d’une antibiothérapie ciblant les bactéries à Gram positif (p. ex.…”

Biocompatible Materials for Orbital Wall Reconstruction—An Overview

“…There are several types of orbital fractures: medial or lateral wall fractures; orbito-zygomatic fractures; LeFort I, II, and III fractures; and naso-orbital ethmoid fractures (Markowitz fractures) [ 5 ]. The most common are orbital floor fractures, medial wall fractures, and zygomatic fractures [ 6 ]. The surgical approach in the case of orbital floor fractures can be either conjunctival, cutaneous, or trans-antral exposure [ 7 , 8 ].…”

Is Surgery Needed for Diplopia after Blowout Fractures? A Clarified Algorithm to Assist Decision-making

“… 1 , 5 , 6 There are various etiologies of diplopia after blowout fractures, including orbital edema, orbital hemorrhage, displacement of periorbital tissues, or injuries to associated nerves or muscles. 2 , 4 , 7 In recent years, there has been a consensus toward an observation strategy before deciding to perform surgical correction within the first 2 weeks of diplopia, except for some urgent conditions, as diplopia may gradually resolve by itself. If diplopia persists after 2 weeks of observation, surgical treatment is usually advised.…”