Orbital Trauma

8.7.1 Review the anatomy of the orbit. Does the nasal bone contribute to the orbit? What are the seven bones of the orbit?

8.7.2 Discuss the medial and lateral canthal tendon anatomy.

8.7.3 Describe the etiology and management of (non-surgical and surgical) traumatic optic neuropathy.

Kountakis SE, Maillard AA, El-Harazi SM, Longhini L, Urso RG. Endoscopic optic nerve decompression for traumatic blindness. Otolaryngol Head Neck Surg. 2000 Jul;123(1 Pt 1):34-7. PMID:10889478

8.7.4 What is an afferent pupillary defect or Marcus Gunn pupil (diagram cranial nerve anatomy)?

8.7.5 What are the principles of enophthalmos correction after orbital blowout? Does it correct diplopia?

Manson PN, Grivas A, Rosenbaum A, Vannier M, Zinreich J, Iliff N. Studies on enophthalmos: II. The measurement of orbital injuries and their treatment by quantitative computed tomography. Plast Reconstr Surg. 1986 Feb;77(2):203-14. PMID:3945683

Wilkins RB, Havins WE. Current treatment of blow-out fractures. Ophthalmology. 1982 May;89(5):464-6. PMID:7099565

8.7.6 Discuss subciliary vs. transconjunctival approach to orbital fractures.

Appling WD, Patrinely JR, Salzer TA. Transconjunctival approach vs subciliary skin-muscle flap approach for orbital fracture repair. Arch Otolaryngol Head Neck Surg. 1993 Sep;119(9):1000-7. PMID:8357580

8.7.7 Discern between a pure and impure orbital blowout fracture.

8.7.8 What is superior orbital fissure syndrome? Orbital apex syndrome? Discuss management of each.

8.7.9 Is CN III neuropathy common after facial trauma?

8.7.10 A 24-year-old man is brought to the emergency department after being struck in the face. CT scan of the face shows an orbital blow-out fracture. Discuss indications for repair.

Manson PN, Iliff N. Management of blow-out fractures of the orbital floor. II. Early repair for selected injuries. Surv Ophthalmol. 1991 Jan-Feb;35(4):280-92. PMID:2011822

8.7.11 In the above patient, would you consider an endoscopic approach to the repair of the orbital floor fracture?

Chen CT, Chen YR. Endoscopically assisted repair of orbital floor fractures. Plast Reconstr Surg. 2001 Dec;108(7):2011-8; discussion 2019. PMID:11743393

Strong EB. Endoscopic repair of orbital blow-out fractures. Facial Plast Surg. 2004 Aug;20(3):223-30. PMID:15643595

8.7.12 Discuss the temporoparietal fascial flap in orbital reconstruction.

Lai A, Cheney ML. Temporoparietal fascial flap in orbital reconstruction. Arch Facial Plast Surg. 2000 Jul-Sep;2(3):196-201. PMID:10938143