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Updated: Jul 27, 2025
Three-Dimensional Reconstruction of Orbital Fractures
Published on: May 16, 2025
Case report on combined approach for delayed orbital floor repair
K P Manoj Kumar1, Aparna S Nair1, T Ajay Das1
1Department of Oral and Maxillofacial Surgery, KMCT Dental College, Kozhikode, Kerala, India.
Insights
Pediatric white-eyed blowout fractures require prompt diagnosis and surgical intervention for optimal outcomes. Delayed treatment in children may necessitate specific grafting techniques for successful orbital reconstruction.
Area of Science:
- Ophthalmology
- Pediatric Surgery
- Maxillofacial Surgery
Background:
- White-eyed blowout fractures in children often present with subtle symptoms, delaying diagnosis.
- Early surgical intervention is crucial for favorable recovery in pediatric orbital fractures.
- Orbital volume changes in pediatric patients necessitate autograft use for reconstruction.
Observation:
- This case report details a pediatric patient with a white-eyed blowout fracture missed for one month.
- The fracture was surgically repaired using a combined mid-tarsal and transantral approach.
- An iliac crest autograft was utilized for orbital floor reconstruction.
Findings:
- Delayed management of pediatric white-eyed blowout fractures can be successfully treated.
- The transantral approach offers excellent visualization and access to the orbital floor.
- Autografts, such as iliac crest, are suitable for correcting orbital volume discrepancies in pediatric patients.
Implications:
- Timely diagnosis and surgical repair of pediatric orbital fractures are essential for preventing long-term complications.
- The transantral approach combined with autografting provides a viable solution for delayed orbital floor reconstruction in children.
- This case highlights the importance of considering orbital fractures even with minimal initial symptoms in pediatric patients.
Abstract:
"White-eyed blowout" fractures in pediatric patients can be presented with fewer clinical symptoms; therefore, immediate diagnosis and surgery is essential. In cases where early surgery was performed, rapid recovery and better postoperative outcomes were noted regardless of the configuration of fracture. In pediatric patients, due to changes in the orbital volume, autograft is recommended. Although there are different approaches to orbital floor, transantral approach provides enhanced illumination and accessibility to orbital floor. This case report portrays a pediatric case of white-eyed blow out fracture which went unnoticed for about 1 month and was managed at a later date. Combined mid-tarsal and transantral approaches using iliac crest graft was used to repair the orbital blow-out fracture.
