Cordula M C Deichmüller1, H-J Welkoborsky2. 1. Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Tumorzentrum, Klinikum Region Hannover GmbH, Klinikum Nordstadt, Haltenhoffstraße 41, 30167, Hannover, Deutschland. hno-deichmueller@t-online.de. 2. Klinik für Hals-Nasen-Ohrenheilkunde, Kopf-Hals-Tumorzentrum, Klinikum Region Hannover GmbH, Klinikum Nordstadt, Haltenhoffstraße 41, 30167, Hannover, Deutschland.
Abstract
BACKGROUND: In the case of trauma to the midface, an accompanying fracture of the orbit is common because to the anatomical conditions (bony buttresses of the midface). Etiology varies according to locoregional conditions. MATERIALS AND METHODS: An overview of orbital traumatology including diagnostic procedures, symptoms and therapy is provided. In addition, our own patient collective over one year including a 5-year follow-up was prospectively analyzed. RESULTS: The possible fractures of the midface with involvement of the orbit including their classifications are listed. The key clinical symptoms and the diagnostic procedure are described. As part of the therapeutic management, in addition to the-mostly required-surgical approach, the conservative therapeutic options and prerequisites for conservative therapy are discussed. In our own patients, clear differences in the accident mechanisms were evident. Violence was the most frequent mechanism for younger, male patients, while in female, elderly patients a fall was the reason for the fracture. Overall, 17% of cases received conservative therapy and 83% underwent surgical treatment. CONCLUSION: Traumatology of the orbit requires that therapeutic decisions be made on an individual patient basis. Even a conservative regime can lead to good results. The treatment of fractures of the orbit and the midface should be in the hands of experienced midface surgeons due to the technical competence with regard to the anatomy of the neighboring structures.
BACKGROUND: In the case of trauma to the midface, an accompanying fracture of the orbit is common because to the anatomical conditions (bony buttresses of the midface). Etiology varies according to locoregional conditions. MATERIALS AND METHODS: An overview of orbital traumatology including diagnostic procedures, symptoms and therapy is provided. In addition, our own patient collective over one year including a 5-year follow-up was prospectively analyzed. RESULTS: The possible fractures of the midface with involvement of the orbit including their classifications are listed. The key clinical symptoms and the diagnostic procedure are described. As part of the therapeutic management, in addition to the-mostly required-surgical approach, the conservative therapeutic options and prerequisites for conservative therapy are discussed. In our own patients, clear differences in the accident mechanisms were evident. Violence was the most frequent mechanism for younger, male patients, while in female, elderly patients a fall was the reason for the fracture. Overall, 17% of cases received conservative therapy and 83% underwent surgical treatment. CONCLUSION: Traumatology of the orbit requires that therapeutic decisions be made on an individual patient basis. Even a conservative regime can lead to good results. The treatment of fractures of the orbit and the midface should be in the hands of experienced midface surgeons due to the technical competence with regard to the anatomy of the neighboring structures.
Entities:
Keywords:
Comminuted fractures; Facial injuries; Orbital fractures; Traumatology; Zygomatic fractures
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