Authors: Martin Gosau Moritz Schöneich Florian G Draenert Tobias Ettl Oliver Driemel Torsten E Reichert
Publish Date: 2010/02/18
Volume: 15, Issue: 3, Pages: 305-313
Abstract
This retrospective study aimed at investigating indications surgical approaches and the materials used for orbital floor reconstructions as well as the clinical followup particularly with regard to postoperative complications This study comprised 189 patients who underwent surgery for fractures of the orbital floor between 2003 and 2007 Diagnosis and treatment were based on both physical examination and computed tomography scan of the orbit Patients were retrospectively analyzed for data such as mechanism of injury classification of fracture and complications The most common cause of injury was physical assault followed by traffic accidents Surgery was conducted with a mean delay of 29 days after the incident Mid lower eyelid incision was the most common surgical approach to the orbital floor For orbital floor reconstruction polydioxanone sheets 705 were mainly used followed by Ethisorb Dura 233 and titanium mesh 62 There were 190 of patients who showed postoperative complications 58 suffered from persisting motility impairment 37 from enophthalmos 32 from consistent diplopia 26 from ectropion and 05 from orbital infection Intraorbital hematoma 32 represented the most severe complications one patient suffered lasting impairment of sight and another one complete blindness of the affected eye If postoperative impairment of vision becomes evident immediate surgical intervention is mandatory Retrobulbar hematoma is more likely to occur in heavily traumatized patients with comminuted fractures and also in patients taking anticoagulative medication The subciliary approach to the orbit and repeated operations by the same approach are associated with a higher risk of developing ectropion
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