Orbital Roof Fracture Management

However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof.

Orbital roof fracture management.

Investigation of orbital fractures is by x ray and ct with ct being the modality of choice though it can be unreliable in children with blowout fractures. The approach used is determined by the surgical needs of the patient. Approaches include extracranial intracranial and endonasal endoscopic. A ct may already be appropriate due to a mechanism of injury or red flags for a head injury.

An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. Nondisplaced or minimally displaced orbital roof fractures are usually managed by observation but displaced orbital roof fractures can cause ophthalmic and neurologic complications and open surgical intervention is occasionally required. Management of orbital roof fractures varies based on individual clinical features including the presence of exophthalmos gaze restriction and concomitant injuries such as dural tears. Mazzoli highlighted this contingency in children because roof fractures are much more common for them than for adults.

In cases of minor isolated orbital roof fractures where no surgical intervention is needed the patient. After a thorough ophthalmic exam and after other trauma has been ruled out the patient and physician. Even in the context of floor fractures dr. When the inner table of the orbital roof is not involved and there is no dural tear the orbital fracture can be accessed by superior orbitotomy.

That s because they go headfirst over handlebars and tend to do a forehead plant. Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases.