Background Orbital roof fractures are frequently associated with a high energy impact to the
craniofacial region, and displaced orbital roof fractures can cause ophthalmic and
neurologic complications and occasionally require open surgical intervention. The
purpose of this article was to investigate the clinical features and treatment outcomes
of orbital root fractures combined with neurologic injuries after early reconstruction.
Methods Between January 2006 and December 2008, 45 patients with orbital roof fractures
were admitted; among them, 37 patients were treated conservatively and 8 patients
underwent early surgical intervention for orbital roof fractures. The type of injuries
that caused the fractures, patient characteristics, associated fractures, ocular and
neurological injuries, patient management, and treatment outcomes were investigated.
Results The patients underwent frontal craniotomy and free bone fragment removal, their
orbital roofs were reconstructed with titanium micromesh, and associated fractures
were repaired. The mean follow up period was 11 months. There were no postoperative
neurologic sequelae. Postoperative computed tomography scans showed anatomically reconstructed
orbital roofs. Two of the five patients with traumatic optic neuropathy achieved full
visual acuity recovery, one patient showed decreased visual acuity, and the other
two patients completely lost their vision due to traumatic optic neuropathy. Preoperative
ophthalmic symptoms, such as proptosis, diplopia, upper eyelid ptosis, and enophthalmos
were corrected.
Conclusions Early recognition and treatment of orbital roof fractures can reduce intracranial
and ocular complications. A coronal flap with frontal craniotomy and orbital roof
reconstruction using titanium mesh provides a versatile method and provides good functional
and cosmetic results.
Keywords
Orbital fracture - Postoperative complication - Optic nerve
