Contemporary Management of Orbital Fractures
Author: Sunthosh Sivam
Base Hospital / Institution: Baylor College of Medicine
Abstract ID: 25-387
Purpose
– To review literature on prediction of delayed enophthalmos following an orbital fracture
– To integrate the use of image-guidance, intra-operative imaging, and patient-specific implants into the management of orbital fracture
– To understand the inter-play between clinical trends in conservative management of orbital trauma and emerging technologies
Methods
A systematic review of the literature predicting delayed enophthalmos was performed. A more updated literature review will also be performed including clinical trends in the use of image-guidance, intra-operative imaging, and patient-specific implants.
Results
High quality prospective studies are lacking in terms of predicting delayed enophthalmos. Involvement of the inferomedial strut (IMS) and rounding of the inferior rectus showed promising data for predicting long term delayed enophthalmos.
Conclusion
Enophthalmos following an orbital fracture can have functional and cosmetic sequelae. Predicting the development of enophthalmos immediately after a trauma remains a clinical challenge. Surgeons who manage orbital trauma try to prevent enophthalmos due to challenges related to dense scarring and under-correcting orbital volume if repair is delayed. However, many technologies that are becoming more widespread can help mitigate some of the challenges of delayed repair. A movement toward conservative management of orbital fractures and simultaneous growth in technology to better handle the challenges of delayed repair are complementary to one another.
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