[Indications of exploration and repair of the orbital floor in fractures of the maxillozygomatic complex].

UNLABELLED: Patients with orbital fractures may develop late complications like enophthalmos, orbital dystopia or diplopia, as a result of untreated orbital floor lesions, with herniation of orbital fat. Clinical and radiological findings are not enough for diagnostic and indication of orbital floor repair.

PURPOSE: To evaluate the indication of repair of the orbital floor, during the surgical treatment of maxillozygomatic or zygomatic-maxillary compound fractures, by means of systemic exploration and to compare clinical with surgical findings.

METHODS

112 patients with unilateral zygomatic-maxillary compound fracture were submitted to exploration of the orbital floor, during the surgical treatment of the fracture. Open reduction and rigid internal fixation was performed with steel wire or miniplates. An autogenous conchal cartilage graft was used to repair the floor lesion, when there was bone loss of the inferior orbital wall and periorbita discontinuity, with fat herniation.

RESULTS

The repair of the orbital floor was indicated in 46.4% of the patients. Early diplopia (before surgery) was observed in 26.6% and enophthalmos in 3.30% of the cases. Among patients with early diplopia, 60% needed repair, while 36.6% of the patients without early diplopia received cartilage graft. No important complications was observed.

CONCLUSION

Orbital floor exploration is a complementary maneuver for the treatment of zygomatic-maxillary compound fractures that permits the precise diagnostic of the lesion and the correct indication of repair.