The management of orbital roof fractures

The nature and aetiology of orbital roof fractures is discussed and a strategy for their successful management outlined with reference to five clinical cases. Early recognition and treatment of these fractures reduces the high incidence of intra-cranial and ocular complications and the importance of a combined approach involving maxillofacial surgeons, neurosurgeons and ophthalmologists is emphasised. A coronal flap together with frontal craniotomy is recommended for surgical access to the orbital roof and overlying dura. When reconstruction is indicated, autogenous bone harvested from the inner table of the calvarium provides an ideal graft material.