Orbital Roof Fractures

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.

Orbital roof fractures.

Often w traumatic optic neuropathy needs spinal cord dose iv steroids maybe decompression w in 5 days see neuro op other fractures. Six patients 10 percent required operative repair of the orbital roof all of whom had a dural laceration and cerebrospinal fluid leak. After review 159 patients 11 percent were found to have true orbital roof fractures with 36 percent being comminuted. Sagittal slices hard tissue window of an isolated right orbital roof fracture.

Coronal slices hard tissue window of the same isolated right orbital roof fracture. He underwent a supraorbital craniotomy for removal of the bony fragment and. Concomitant craniofacial skeletal fractures were common 87 percent as were ophthalmologic injuries 47 percent and traumatic brain injury with intracranial hemorrhage 65 percent. 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. Might have intracranial lesions csf rhinorrhea pneumocephalus. Background oculorrhea or cerebrospinal fluid leakage developing from a cranio orbital fistula is a rare development following traumatic injury. Exposure of orbital roof fractures is normally via preexisting lacerations upper blepharoplasty incisionsor probably most often via coronal approach.

A total of 1484 pediatric patients carried the diagnoses of orbital fracture or anterior skull base fracture. Orbital roof fracture icd 801 01 etiology. It s called a tripod fracture or a zygomaticomaxillary complex zmc fracture. 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.

A common type of orbital rim fracture involves all three major parts of the eye socket. Most orbital roof fractures are blow in fractures displacement of the bone is towards the orbit. The approach used is determined by the surgical needs of the patient. The following pages provide general information regarding orbital anatomy and dissection.

Once the orbital floor is exposed periorbital dissection is performed. Approaches include extracranial intracranial and endonasal endoscopic. Fractures of the orbital roof typically require a significant amount of force. Look for csf rhinorrhea cartoid cavernous cc fistula.