Čes. stomatol. Prakt. zub. lék. (Czech Dental Journal) 2014; 114(5): 61-68 | DOI: 10.51479/cspzl.2014.031

Isolated orbital floor fractures

R. Mottl^1,*, R. Slezák¹, A. Feuermannová³, J. Laco², A. Mottlová¹, Z. Janovská¹

¹ Stomatologická klinika

² Fingerlandův ústav patologie

³ Oční klinika LF UK a FN, Hradec Králové

Introduction, Aim: Orbital fractures, especially orbital floor fractures, are relatively common type of facial fractures. Fracture severity ranges from small minimally displaced fractures of an isolated wall that require no treatment to major disruption of the orbit that require surgical intervention. The main goal of the surgical therapy is an optimal anatomical reconstruction of the orbit leaving no functional or cosmetic defects. Indication and timing of the surgical intervention is based on the results of clinical findings and radiologic examination, preferably computed tomography scanning. Magnetic resonance images can be used for characterization of soft-tissue sequelae and complications. Close cooperation between the maxillofacial surgeon and the ophthalmologist plays an important role in the management of the orbital floor fractures.
There are several types of both resorbable and non-resorbable materials for the orbital reconstruction. Polydioxanon sheets are frequently used in orbital floor repair. This material has very good biocompatibility, but it is not sufficient for the reconstruction of defects larger than 2,5 cm². Titanium mesh is a non-resorbable material used in cases of huge bone defects. Mediopalpebral approach is considered to be the best surgical approach with very few complications, both aesthetic and functional. Transconjunctival approach is useful and plays an important role, too. Nevertheless, complications such as enophtalmos, diplopia or loss of vision handicapping the patients in their everyday life can occur even if adequate treatment was provided.

Conclusion: We expect the number of orbital trauma will increase in the future. Nowadays, there are many new materials and procedures in the treatment of orbital fractures, which could improve prognosis of the treament. The main goal of the review is to summarize the evaluation and management of orbital floor fractures.

Keywords: isolated orbital floor fracture; diplopia; enophtalmos; mediopalpebral approach; surgical therapy

Published: December 1, 2014  Show citation