Isolated orbital blowout fractures: survey and review

The management of orbital blowout fractures is controversial. The continuing debate includes the use of antibiotics and steroids, imaging, the surgical approach, and the choice of implant material for repair of the bony defect.A cross-sectional study was undertaken to assess current practice in treating orbital blowout fractures in the UK, in the form of a tick-box questionnaire. The questionnaire contained 9 closed and 2 open questions, and was forwarded to 256 practising fellows of the British Association of Oral and Maxillofacial Surgery. The response rate to the questionnaire was 73% (187/256). There was no consensus about the use of prophylactic antibiotics. However, 91% prescribed post-operative antibiotics and over half the respondents prescribed steroids. The most common imaging techniques used were computed tomography (CT, 88%) and plain radiograph (83%), 60% routinely sought an ophthalmic opinion and 65% assessed visual acuity. The most common surgical approaches were the subciliary (41%) and the infraorbital (37%), over half the respondents preferred to operate 6-10 days after the injury, and silicone elastomer was the preferred implant material of 66%.