Abstract
Introduction: Orbital floor fractures are a significant pathology among maxillofacial injuries. They can cause oculomotor, sensory, and sometimes esthetic disorders. The goal of this study was to determine the epidemiological profile of orbital floor fractures and show their clinical and therapeutic approach in Lomé. Patients and method: This was a descriptive retrospective study of orbital floor fractures collected in the ENT and maxillofacial surgery department of Sylvanus Olympio University Hospital in Lomé over 8 years (January 1, 2011 to December 31, 2018). Results: We reviewed 63 cases of orbital floor fractures out of 552 cases of facial trauma. According to the inclusion and non-inclusion criteria, we retained 51 cases. The hospital frequency of orbital floor fractures was 9.24% of facial fractures. The average age of the patients was 35 ± 10.34 years. Males were predominant (ratio = 7.5). The main etiology was road accidents (92.16%). Ophthalmological signs were dominated by vertical diplopia (31.37%), limited eye movement (25.49%), and enophthalmia (29.41%). The sensory sign was dominated by suborbital hypoesthesia (13.73%). Surgical treatment was performed in 86.27% of patients. The average intervention time was 17.84 ± 12.69 days after the trauma. The main approach was the subciliary route (65.91%). The surgical procedures consisted of muscle and fat removal (20.45%) and orbital floor repair by mesh plate (50%). The average length of hospitalization was 9.63 ± 5.23 days. Surgical site infection was the main postoperative complication observed in 3.92% of patients. The main sequelae were diplopia (4.55%), suborbital hypoesthesia (4.55%), and enophthalmos (4.55%). Conclusion: Orbital floor fractures are mainly due to road accidents. Management must be multidisciplinary and adequate in order to avoid irreversible functional and/or morphological sequelae. Their prevention consists of effective combat of road accidents.
Highlights
Orbital floor fractures are a significant pathology among maxillofacial injuries
Patients and method: This was a descriptive retrospective study of orbital floor fractures collected in the ENT and maxillofacial surgery department of Sylvanus Olympio University Hospital in Lomé over 8 years (January 1, 2011 to December 31, 2018)
We reviewed 63 cases of orbital floor fractures out of 552 cases of facial trauma
Summary
Orbital floor fractures are a significant pathology among maxillofacial injuries. They can cause oculomotor, sensory, and sometimes esthetic disorders. Orbital floor fractures are common and mainly affect young adult males [1] [2] They occur during road accidents, aggressions, fights, or sports accidents [1] [3]. For the indirect or hydraulic mechanism, this is a trauma carried to the eyeball by a blunt object which diameter is equal to that of the orbital frame, during a frontal impact, the eyelids being closed. This shock displaces the contents of the orbit backward and causes a sudden increase in intra-orbital pressure [4]. Two possibilities can arise: either the rim breaks but without displacement and the fracture radiates to the floor of the orbit (impure blow-out), or the orbital rim bends without breaking, and the orbit floor collapses under the shock wave (pure blow-out) [4]
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