[Current approaches to surgical treatment for cranioorbital injuries]

A hundred and two victims (120 reconstructive operations) with cranioorbital injuries were operated on at the N. N. Burdenko Institute of Neurosurgery in different periods after injury in 2000 to 2005. In 69 (67.6%) of the 102 patients (82 operations) bone autografts, mainly calvarial ones (61 operations in 55 victims), were used. The operations were performed, by utilizing both neurosurgical and ophthalmoplastic techniques and up-to-date craniofacial surgical procedures. The basic principle of surgical treatment for cranioorbital injuries was three-dimensional orbital anatomy restoration, such as the stabilization and repair of the orbital rim and one-stage reconstruction of the afflicted walls. Computed tomography provides main information for the efficient planning of a surgical intervention. Optimal cosmetic and functional results are attained when primary reconstructive surgery is made in the acute or early (10-14 days) periods after injury. Secondary cranioorbital reconstructive surgery may be performed in one or several steps in relation to the severity and signs of bone structural injuries and to the state of soft tissues. A bone autograft is the material of choice for repair of all portions of the cranioorbital region.