What is the orbital floor anatomy in a Blowout fracture?

From the Guidelines

The orbital floor anatomy in a Blowout fracture is primarily composed of the maxillary bone, with contributions from the zygomatic and palatine bones, and contains the infraorbital groove and foramen, which allow passage of the infraorbital nerve and vessels. When considering the management of Blowout fractures, it is essential to understand the orbital floor anatomy to determine the best course of treatment, as described in the adult strabismus preferred practice pattern 1. Key aspects of the orbital floor anatomy include:

• The maxillary bone as the primary component
• Contributions from the zygomatic and palatine bones
• The presence of the infraorbital groove and foramen
• The potential for muscle entrapment and oculocardiac reflex in cases of Blowout fracture, which may require immediate repair, as indicated in the adult strabismus preferred practice pattern 1. In the context of Blowout fractures, understanding the orbital floor anatomy is crucial for diagnosing and treating conditions like diplopia, enophthalmos, and hypoglobus, and for determining the optimal timing for repair, whether immediate, within 2 weeks, or delayed 1.

From the Research

Orbital Floor Anatomy in Blowout Fractures

The orbital floor anatomy in blowout fractures is complex and involves various structures.

• The orbital floor is the thinnest bone of the orbit and is prone to fractures 2, 3, 4, 5, 6.
• Blowout fractures typically occur when there is a sudden increase in intraorbital pressure, causing the orbital floor to fracture and potentially leading to herniation of orbital contents into the maxillary sinus 2, 3, 4, 5, 6.
• The anatomy of the orbital floor includes the maxillary sinus, the inferior orbital fissure, and the infraorbital nerve 4, 5.

Surgical Management

Surgical management of orbital floor fractures is often necessary to restore orbital anatomy and prevent complications such as diplopia, enophthalmos, and infraorbital dysthesia.

• Various materials can be used for orbital floor reconstruction, including titanium meshes, resorbable implants, and autologous bone grafts 2, 4, 5.
• The choice of material and surgical approach depends on the size and location of the fracture, as well as the presence of any associated injuries 2, 4, 5, 6.
• Minimally invasive endoscopic surgery is a novel approach that has been shown to be effective in managing orbital floor fractures 4.

Complications and Outcomes

Complications of orbital floor fractures can include diplopia, enophthalmos, and infraorbital dysthesia.

• Studies have shown that surgical repair of orbital floor fractures can lead to significant improvement in these symptoms 2, 3, 4, 5.
• The timing of surgical intervention is also an important consideration, with some studies suggesting that delayed surgery may be beneficial in certain cases 3.