Reconstructing a Traumatic Empty Orbit: Principles, Difficulties of Treatment, and Literature Review

Journal of Oral and Maxillofacial Surgery : Official Journal of the American Association of Oral and Maxillofacial Surgeons
Panagiotis Stathopoulos, Philip Ameerally

Abstract

This report describes the case of a serious orbital injury in which the globe was completely displaced into the nasal cavity and the orbit was clinically empty. The authors discuss the difficulties encountered in the management of this patient and their principles in the reconstruction of a complex defect. In this rare case of severe injury, the authors used a combined transconjunctival and ethmoidal approach to retrieve the displaced globe from the nasal cavity. This approach allowed ample access to the floor and the medial wall of the orbit; therefore, a single 0.5-mm titanium mesh was bent to fit the combined defect for reconstruction. Early combined maxillofacial and oculoplastic surgical intervention resulted in salvage and restoration of the eye with preservation of vision. Stable reconstruction of the maxillo-ethmoidal buttress is of great importance in patients with comminuted injuries. This strut determines the appropriate orbital volume and defines the position of the eye in space. Patients with insufficient restoration of the buttress are always at risk of developing enophthalmos. To replicate the contour of the S-shape of the orbital floor and the slope of the medial wall, the authors support the use of thin implant...Continue Reading

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