Blow-out fractures of the orbit —Surgical indications and approaches—

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  • 眼窩吹き抜け骨折

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Although orbital blow-out fracture is a common disease, the indications and timing for surgery are still controversial. Since spontaneous resolution of ocular motility disturbance is seen in some cases, observation for up to two weeks is recommended. If the findings of computed tomography (CT) reveal linear fracture with muscular strangulation, operation must be performed urgently. In cases with large orbital floor fractures or early enophthalmos after the injury, early surgical exploration should be considered. Although endonasal or transmaxillary repair of blow-out fracture using endoscopy usually results in satisfactory outcomes, residual enophthalmos is occasionally seen in patients with large bony defects. In such cases, reconstruction of the orbital floor by a transorbital approach is necessary. Optimal surgical timing and optimal surgical approach through careful evaluation of the CT findings and ophthalmologic examinations result in good outcomes.

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