Isolated orbital floor fractures are more frequent due to low bone thickness (2 mm). The aim of this study was to conduct a retrospective epidemiological analysis on these fractures, investigating demographic variables and fractures\' features and their statistical correlation. A total of 120 patients with isolated orbital floor fracture, admitted at the Maxillofacial Surgery Unit of University of Naples Federico II, from 2010 to 2022 were enrolled in the study. Patients were evaluated for age, sex, smoke, comorbidities, post-traumatic clinical manifestation,s and defect side and size. Statistical analysis was conducted using the Pearson regression coefficient (r). The fractures were more frequent in men (male:female 2.2:1) because of road accidents (30% of cases). The average age was 48 years. Enophthalmos, diplopia and ocular motility anomalies were observed in 31%, 23% and 21% of cases, respectively. Statistical analysis revealed that age was related to fracture area; in particular, older patients showed larger fractures (p < 0.001). Interpersonal violence and traffic accidents were related to younger age (p < 0.001). Data analysis revealed that isolated orbital floor fractures are more frequent in young men (<40 years) because of road accidents or interpersonal violence. There is a statistical correlation between fracture area and patient age; in particular, older age corresponds to larger defects.

OBJECTIVE: The aim of the study Id to determinate of objective criteria for the choice of operative access in fractures of the lower wall of the eye socket.
METHODS: As an objective assessment of surgical approaches, the magnitude of the surgical action and the wound depths are used. Computer modeling of transorbital and transantral surgical approach is performed on 390 eye sockets based on computed tomograms with a virtual representation of the eye structure of fractures of the anterior, middle and posterior parts. In case of orbital floor fractures in the anterior part, both transorbital and transantral approaches have satisfactory indicators of operational impact.
RESULTS: For fractures in the posterior part, the transorbital approach in the overwhelming majority of cases shows unsatisfactory parameters of objective criteria. For fractures in the middle part, the transantral approach shows the better parameters. The parameters of transorbital access in this case can be considered satisfactory, however, in orbital floor fractures of the middle part, in order to place the implant on undamaged areas of the bone, access to the posterior part of the orbital floor is also required, which leads to unsatisfactory indicators of transorbital access in this situation.
CONCLUSIONS: For fractures in the anterior orbital floor sections, both transorbital and transantral approaches can be used, and for fractures in the middle and posterior parts, the transantral surgical approach is preferable. In case of accompanying trauma of the medial orbital wall and an anterior part of the orbital floor, transorbital access is preferable, and in the case of the same accompanying injury, but with a fracture of the posterior part of the orbital floor, a combined approach from the orbit and maxillary sinus can be used.
UNASSIGNED: Определение объективных критериев выбора оперативного доступа при переломах нижней стенки глазницы.
UNASSIGNED: В качестве критериев объективной количественной оценки хирургических доступов использовали угол операционного действия и глубину раны. На 390 глазницах выполняли компьютерное моделирование трансорбитального и трансантрального хирургических доступов на основе данных компьютерных томограмм с виртуальным представлением переломов нижней стенки глазницы в передних, средних и задних отделах.
UNASSIGNED: При переломах нижней стенки глазницы в передних отделах как трансорбитальный, так и трансантральный доступы обладают удовлетворительными показателями оперативного воздействия. При переломах в задних отделах трансорбитальный доступ в большинстве случаев показывает неудовлетворительные параметры объективных критериев. При переломах в средних отделах лучшие параметры критериев показывает трансантралный доступ. Параметры трансорбитального доступа в данном случае могут считаться удовлетворительными, однако при переломах нижней стенки глазницы в средних отделах с целью укладки имплантата на неповрежденные участки кости требуется доступ и к задним отделам нижней стенки, что возвращает к неудовлетворительным показателям трансорбитального доступа в данной ситуации.
UNASSIGNED: При переломах в передних отделах нижней стенки глазницы могут быть использованы как трансорбитальный, так и трансантральный доступы, а при переломах в средних и задних отделах предпочтителен трансантральный оперативный доступ. При сопутствующей травме медиальной стенки глазницы и переломе передних отделов нижней стенки наиболее благоприятным является трансорбитальный доступ. В случае такой же сопутствующей травмы, но при переломе задних отделов нижней стенки глазницы может быть использован комбинированный доступ из глазницы и верхнечелюстной пазухи.

UNASSIGNED: Orbital floor Fractures are the most common fractures involving the facial skeleton and usually occurs after traumatic events. The reconstruction of the orbital floor can be performed with different biocompatible materials. The aim of our retrospective study is to analyze the short- and long-term outcomes of surgically treated patients based on the material used to repair the orbital floor.
UNASSIGNED: We enrolled 146 patients hospitalized for orbital floor fractures in the Maxillofacial Surgery Unit of the Federico II University of Naples from 1 to 2010 to July 2020. All the fractured orbital floors were reconstructed with non-resorbable (Titanium Mesh, SynPor, SuPor and MedPor implants) or resorbable (collagen membrane, bovinum pericardium membrane, autologous bone graft) materials.
UNASSIGNED: We utilized non-resorbable materials in 56% (82 cases) and resorbable implants in 44% (64 cases). An improvement of the preoperative symptomatology and an aesthetical good outcome was achieved in most cases.
UNASSIGNED: Data obtained supports that both resorbable and non-resorbable materials for orbital floor reconstruction are a safe and effective alternatives and offer satisfactory results in functional and aesthetic evaluations.

Orbital floor fracture is common in facial trauma patients. Although treated through surgical repair, the orbital floor fractures are associated with risk of persisting sensibility disorders, enophthalmos, and permanent diplopia due to complex anatomy of the orbit, time of surgery, and the reconstructive material used for such repairing.Failure of early recognition and treatment of these traumatic injuries may result in functional and cosmetic problems. Autogenous bone grafts are the gold standard for reconstruction of maxillofacial defects. The iliac crest is also considered the most ideal donor site for bone grafting when a large amount of bone is needed.
To assess the outcome of early repair of orbital floor fractures regarding enophthalmos, double vision, extrusion, and gait disturbance.
A total of 15 patients, all with orbital floor fracture, were enrolled, of which 12 of them were having pure blow-out fractures and 3 patients had impure blow-out fractures. All had undergone primary surgical reconstruction of the orbital floor by autogenous anterior iliac crest within 5-14 days of the injury.
The results were as follows: Postoperative complications at recipient site included diplopia (13.3%), enophthalmos (6.7%), and extrusion (6.7%). At the donor site, one patient had pain and the other had gait disturbances, both relieved within 1 month after treatment.
Less complications were reported postoperatively with the use of nonvascularized autogenous iliac bone graft.

UNASSIGNED: The purpose of this study was to assess the use and accuracy of the titanium micromesh for primary internal orbital reconstruction in cases of either pure or impure orbital blowout fractures.
UNASSIGNED: Retrospective case series of 21 patients with a mean follow-up of 12 months.
UNASSIGNED: Department of Dental Surgery of a teaching tertiary medical college Hospital.
UNASSIGNED: Twenty-one consecutive patients who underwent surgical reconstruction of orbital floor/or Combination of floor and rim fractures using titanium micromesh.
UNASSIGNED: Persistence of diplopia, orbital dystopia, implant extrusion, enophthalmos, infection, and complications. The recorded data included age, gender, cause of trauma, diplopia, enophthalmos, ocular motility, preoperative orbital PNS/CT, and postoperative paranasal sinus view skull preoperative and postoperative ophthalmological examination.
UNASSIGNED: Most of the patients were males and resulted from trauma inflicted during RTA, sport injuries or assault. The most Common fracture pattern was impure Blow out fractures, and commonly associated other facial fractures were midfacial fractures. Clinical examination along with diagnostic aids such as computed tomography of orbital fractures was used. Orbital floor exploration was performed in 21 cases due to functional or aesthetic deficits. All orbital floor bone defects required reconstruction. In these cases, orbital floor was reconstructed with .3 mm titanium micromesh implant. We did not encounter any major complications related to the incisions or implant material, though sample size was small. The rate of complication in which correction was difficult (diplopia) was lower [4%, 1 case].
UNASSIGNED: Titanium mesh gives excellent result in orbital floor fractures. Surgical anatomical landmarks knowledge is very important to prevent any intra- or postoperative complications.

UNASSIGNED: Orbital floor fractures are common among mid-face fractures. The general aim of treatment is to restore orbital volume and anatomy with grafts or reconstructive materials. Malpositioning of the implants and inadequate volume restorations are common complications of these procedures. The aim of our study is to present the surgical outcomes of orbital reconstruction aided by our algorithm of patient-specific virtual planning.
UNASSIGNED: The current study was performed on 77 patients with orbital wall fractures who were categorized into two groups: Group A - 42 patients (virtual planning) and Group B - 35 patients (traditional approach). Criteria of analysis included the presence of diplopia postoperatively and duration of surgical procedures.
UNASSIGNED: Diplopia was recorded right after surgery in 16 cases (38.1%) of Group A and in 12 cases (34.3%) of Group B. However, 6 months postreconstruction, residual diplopia was recorded in 4 cases (9.5%) of Group A and in 12 cases (34.3%) of Group B. Mean operation time in Group A for the patients with isolated zygoma fracture was 2.23 h; for isolated orbital wall fracture was 1.98 h; and for combined zygoma, orbital wall, and facial bone fracture was 3.07 h. In Group B, these indexes were 3.47, 2.05, and 3.31 h, respectively.
UNASSIGNED: Application of virtual planning could significantly improve postoperative outcomes in orbital reconstruction. However, application of this technology could be limited by complicated defects of the orbital walls, which would require complex shape of the implant that might be difficult to be prevent virtually.

暂无摘要。

OBJECTIVE: Primary reconstruction via transconjunctival approach is a standardized treatment option for orbital floor fractures. The aim of this study was to compare the findings of specific ophthalmologic assessment with the patient\'s complaints after fracture reduction.
METHODS: A retrospective medical chart analysis was performed on patients who had undergone transconjunctival orbital floor fracture reduction for fracture therapy with resorbable foil (ethisorb sheet or polydioxanone foil). A follow-up assessment including ophthalmological evaluation regarding visual acuity (eye chart projector), binocular visual field screening (Bagolini striated glasses test) and diplopia (cover test, Hess screen test) was conducted. Additionally, a questionnaire was performed to assess patients\' satisfaction.
RESULTS: A total of 53 patients with a mean follow-up of 23 months (ranging from 11 to 72) after surgical therapy were included. Diplopia was present preoperatively in 23 (43.4%) and reduced in follow-up examination (n = 12, 22.6%). Limitations in ocular motility reduced from 37.7% to 7.5%. The questionnaire about the patient\'s satisfaction revealed excellent outcomes in relation to the functional and esthetical parameters.
CONCLUSIONS: Transconjunctival approach is a safe approach for orbital fracture therapy. Postoperative diplopia is nearly never perceptible for the individual and differs to pathologic findings in the ophthalmic assessment.

OBJECTIVE: Evidence on the best surgical approach with the lowest lower lid complications (LLCs) in the treatment of orbital floor (OF) and periorbital fractures (POFs) is limited because of the absence of head-to-head studies. We performed this network meta-analysis (NMA) to compare various surgical approaches in treatment of OFs and POFs, with respect to LLCs.
METHODS: This NMA based on PRIMSA guidelines studied the incidence of the LLCs among various surgical approaches in the treatment of the OFs and POFs. We searched several databases from 1970 to March 2018. All clinical studies comparing different surgical approaches in treatment of OFs and POFs were included. Outcome variables were ectropion, entropion, scleral show and other complications. Predictor variables were transconjunctival approach (TCA), subciliary approach (SCA), subtarsal approach (STA) and infraorbital approach (IOA). Frequentist NMA was performed using STATA software.
RESULTS: A total of 47 studies with 5267 cases of the OFs and POFs received ORIF using 4 surgical approaches with 6 comparisons were included. TCA significantly reduces the prevalence of ectropion than SCA (OR = 3.54, CI1.28-9.84), but no significant difference was found between TCA and, STA or TCA and IOA. SCA and STA significantly reduce the prevalence of entropion than TCA (OR = 5.02, CI, 1.79-14.06, OR = 0.11, CI, 0.02-0.57) respectively. We found no significant difference between the 6 comparisons with respect to other complications.
CONCLUSIONS: This NMA shows that the application of various surgical approaches leads to different incidences of LLCs. While TCA appears to have the lowest overall LLCs rate, STA has lowest rate among the transcutaneous approaches. The choice of an appropriate surgical approach for a given fracture should take these among other factors into consideration. Owing to the limitations of this study, we suggest that the results be interpreted with caution.

Management of orbital floor fracture remains the most debated topic in maxillofacial field. There are many approaches to reconstruct orbital floor fractures and restore orbital position and function, but many have the drawback of incomplete visualization, especially of the posterior part of the orbit. Pain, diplopia and enophthalmos are the most common presenting symptoms in patients who sustained orbital blow out fracture. The main aim in treating orbital fracture is to reduce the prolapsed orbital tissue and reconstruct the floor which will improve diplopia and enophthalmos. As minimally invasive surgical techniques are gaining popularity, it is possible to reconstruct the orbital fracture defects using endoscopes. Endoscopic assisted combined transantral and subciliary technique provides better surgical access and outcome in the treatment of orbital floor fracture.