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Clinical management and reconstruction of isolated orbital floor fractures: the role of computed tomography during preoperative evaluation

Nesrin Tan Başer, Refika Bulutoğlu, Nihal Uzun Celebi, Gürcan Aslan
Turkish Journal of Trauma & Emergency Surgery: TJTES 2011, 17 (6): 545-53

BACKGROUND: A common consent regarding repair indications, timing of repair and choice of reconstruction materials for isolated orbital base fractures does not yet exist.

METHODS: We retrospectively reviewed our patients (41 male, 13 female) who were operated due to a diagnosis of isolated orbital floor fracture between 2002 and 2010.

RESULTS: Fifty-four patients diagnosed with isolated orbital base fracture were found; 49 of 54 patients required surgery. The indications for surgery were restricted ocular motility and marked enophthalmos in 20.4% of the patients, whereas in 79.6%, surgical intervention was decided largely based on the coronal computed tomography images. 36.7% of the cases were operated earliest, in the first 16 hours, and 10.2% were operated the latest, in 72-96 hours. Ultra-thin porous polyethylene was used in the orbital base repair. Twelve patients contacted for this study were evaluated. Enophthalmia and exophthalmia were in normal limits in patients, and none of the patients displayed ectropion or scleral show findings or reported any complaints related to scar formation.

CONCLUSION: When not treated in a timely manner and with appropriate materials, orbital base fractures might result in enophthalmia and diplopia. We believe that a good prognosis of orbital base fractures relies on the right decision for surgical indication, early surgical intervention, and repair with appropriate material.

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