ORBITAL FRACTURES

Dr V.RAMKUMARCONSULTANT DENTAL&FACIOMAXILLARY

SURGEONREGNO: 4118 –TAMILNADU-INDIA-(ASIA)

INTRODUCTION

Orbit is a pyramidal cavity on each side of the nose.

The average adult orbital volume is 30 cc

SUPERIOR ORBITAL FISSURE

Anatomy of the bony orbit

The bones which forms the orbit consist of

Maxilla

Zygoma

Lacrimal sphenoid

Ethmoid

Palatine bone

Parts of the orbit

Roof

Medial wall

Lateral wall

Floor (relatively thin)

Contents of the orbit

Eye ball

Fascia (orbital bulbar)

Muscles( etraocular involuntary)

Vessels(opthalmic)

Nerves(2,3,5,7)

Lacrimal gland

Orbital fat

Classification of orbital fractures

pure blow out #

# of the floor of the orbit without the involvement of orbital rim

Impure blow out #

# of the orbital rim

Movement of eye ball - Muscle

upward rotation - superior rectus or elevation inferior obliqueDownward rotation - superior oblique or depression inferior rectusMedial rotation - medial superior, Or adduction inferior rectus Lateral rotation - lateral rectus, or abduction superior, inferior oblique

Intortion - superior obliqe

superior rectus

Extortion - Inferior oblique

inferior rectus

Movement of the eye ball

Transverse axisUpward rotation - Elevation 33`Downward rotation- Depression 33`

vertical axis Medial rotation- Adduction 55` lateral rotation – Abduction 55`

AP Axis Intortion Extortion

ACTION OF EXTRAOCULAR MUSCLE

CLINICAL SIGNS AND SYMPTOMS OF ORBITAL #

INCREASE INTERCANTHAL DISTANCE

SUB CONJUNCTIVAL ECHHYMOSIS

OEDEMA

HANGING DROP APPERANCE OF FAT

INVESTIGATIONS

PNS VIEW

SKULL PA VIEW

WATERS VIEW

complications of orbital fractures

paralysis of muscle

Diplopia

Nystagmus

Retrobulbar hemmorhage

Cavernous sinus thrombosis