Orbital Roof Fractures

The following pages provide general information regarding orbital anatomy and dissection.

Orbital roof fractures.

Fractures of the orbital roof typically require a significant amount of force. When they do happen they may be associated with intracranial hemorrhages traumatic optic neuropathy and csf leakage into the orbit. One hundred five patients returned after discharge average follow up 19 months. 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.

Most orbital roof fractures are blow in fractures displacement of the bone is towards the orbit. 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. Isolated orbital roof fractures in adults are uncommon comprising 12 19 of all orbital wall fractures. Concomitant craniofacial skeletal fractures were common 87 percent as were ophthalmologic injuries 47 percent and traumatic brain injury with intracranial hemorrhage 65 percent.

Coronal slices hard tissue window of the same isolated right orbital roof fracture. Look for csf rhinorrhea cartoid cavernous cc fistula. Often w traumatic optic neuropathy needs spinal cord dose iv steroids maybe decompression w in 5 days see neuro op other fractures. Might have intracranial lesions csf rhinorrhea pneumocephalus.

Approaches include extracranial intracranial and endonasal endoscopic. Background oculorrhea or cerebrospinal fluid leakage developing from a cranio orbital fistula is a rare development following traumatic injury. Orbital roof fracture icd 801 01 etiology. A total of 1484 pediatric patients carried the diagnoses of orbital fracture or anterior skull base fracture.

Six patients 10 percent required operative repair of the orbital roof all of whom had a dural laceration and cerebrospinal fluid leak. Sagittal slices hard tissue window of an isolated right orbital roof fracture. It s called a tripod fracture or a zygomaticomaxillary complex zmc fracture. Once the orbital floor is exposed periorbital dissection is performed.

Exposure of orbital roof fractures is normally via preexisting lacerations upper blepharoplasty incisionsor probably most often via coronal approach. After review 159 patients 11 percent were found to have true orbital roof fractures with 36 percent being comminuted. 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. The approach used is determined by the surgical needs of the patient.