[Fractures of the orbital floor. Review of 346 cases]

From 1976 to 1988 346 fractures of the orbital floor were repositioned in the ENT-Department of the University of Mainz. 145 (41.9%) cases were pure orbital fractures, in 201 (58.1%) cases the fractures were extended. Assaults followed by accidents were the most frequent causes of injury. Preoperatively, diplopia and enophtalmus were among the most frequent symptoms, followed by fracture of the orbital rim, parestesias or anestesias of the infraorbital nerve and limitation of ocular motility. A support of the orbital floor was necessary in 122 (32.7%) of the cases, which was achieved by a modified vesical Foley catheter. In 194 (56.1%) patients lyofilized dura was used to cover the repositioned bone fragments. The orbital floor had to be reconstructed in 37 cases (10.7%) with autologue cartilage or bone. Supplementary wiring was necessary in 95 (27.5%) cases. In the follow up, diplopia and alterations of the infraorbital nerve were studied. 176 (50.8%) of the patients had diplopia with or without alterations of ocular motility, which was confirmed by routinely performed explorations in the Department of Ophthalmology. In 24 (6.9%) cases light alterations of ocular motility persisted six months postoperatively. 113 (32.7%) patients referred parestesias of the infraorbital region, persisting in 40 (11.6%) patients for at least six months.