Orbital Roof Fracture Management

In cases of minor isolated orbital roof fractures where no surgical intervention is needed the patient.

Orbital roof fracture management.

Approaches include extracranial intracranial and endonasal endoscopic. 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. 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.

A ct may already be appropriate due to a mechanism of injury or red flags for a head injury. Traumatic orbital roof fractures are rare and are managed nonoperatively in most cases. Surgically bicoronal approaches were performed most commonly along with reconstruction utilizing titanium miniplates. 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.

However intracranial or intraorbital injury may warrant surgical intervention to remove impinging bony fragments repair dura or reconstruct the orbital roof. Another potential emergency involves the roof not the floor of the orbit. After a thorough ophthalmic exam and after other trauma has been ruled out the patient and physician. The approach used is determined by the surgical needs of the patient.

An interdisciplinary approach with plastic surgery ophthalmology and neurosurgery is crucial to providing comprehensive care. 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.