Orbital Roof Fractures

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.

Orbital roof fractures.

When they do happen they may be associated with intracranial hemorrhages traumatic optic neuropathy and csf leakage into the orbit. The approach used is determined by the surgical needs of the patient. Look for csf rhinorrhea cartoid cavernous cc fistula. Background oculorrhea or cerebrospinal fluid leakage developing from a cranio orbital fistula is a rare development following traumatic injury.

This frequently causes downward and forward displacement of the globe. Case report a 22 year old man involved in a motor vehicle accident developed a blowout fracture of the left orbital roof penetrating the frontal lobe inducing oculorrhea. Exposure of orbital roof fractures is normally via preexisting lacerations upper blepharoplasty incisionsor probably most often via coronal approach. Might have intracranial lesions csf rhinorrhea pneumocephalus.

A total of 1484 pediatric patients carried the diagnoses of orbital fracture or anterior skull base fracture. Once the orbital floor is exposed periorbital dissection is performed. Sagittal slices hard tissue window of an isolated right orbital roof fracture. Isolated orbital roof fractures in adults are uncommon comprising 12 19 of all orbital wall fractures.

Most roof fractures are associated with other orbital fractures and result from significant head trauma as a high degree of force is required to fracture this portion of the orbit. Coronal slices hard tissue window of the same isolated right orbital roof fracture. It s called a tripod fracture or a zygomaticomaxillary complex zmc fracture. He underwent a supraorbital craniotomy for removal of the bony fragment and.

A common type of orbital rim fracture involves all three major parts of the eye socket. Six patients 10 percent required operative repair of the orbital roof all of whom had a dural laceration and cerebrospinal fluid leak. Concomitant craniofacial skeletal fractures were common 87 percent as were ophthalmologic injuries 47 percent and traumatic brain injury with intracranial hemorrhage 65 percent. Often w traumatic optic neuropathy needs spinal cord dose iv steroids maybe decompression w in 5 days see neuro op other fractures.

The following pages provide general information regarding orbital anatomy and dissection. Approaches include extracranial intracranial and endonasal endoscopic. Orbital roof fracture icd 801 01 etiology. After review 159 patients 11 percent were found to have true orbital roof fractures with 36 percent being comminuted.