BLOWOUT fracture of the floor of the orbit
ABSTRACT
Blowout fractures of the orbit, a frequent
complication of inidfacial trauma, result
from an increased intraorbital pressure
which "blows out" the weakest area-the
floor. Intraorbital fat and muscles herniated
into the maxillary sinus, muscles incarcerated
in the fracture, and the displaced
orbital contents produce diplopia. After
incarceration, elevation of the affected eye
is impossible.
Diagnosis is frequently difficult because
initial intraorbital hemorrhage may limit
mobility. Tomograms in the Waters' projection
may show the fracture but frequently
reveal only a cloudy antrum. The
muscle traction test described herein is
most helpful.
The surgical correction aims at bridging
the defect with Teflon or stainless-steel
mesh or endogenous bone graft placed
beneath the periosteum. Entry is gained
through the lower lid. If repafred early,
there is no functional loss arid the repair
is cosmetically excellent.
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