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Orbital and Facial Fractures, Treatment Reviewed by Dr. S. Chidyllo, Board Certified Plastic Surgeon
The treatment of Orbital and Orbital Floor Fractures after facial trauma is a complex and delicate surgical procedure. A majority of Orbital and Orbital Floor Fractures are caused by blunt facial trauma sustained in Sports and Automobile Accidents.
Fractures of the orbital bones are commonly seen after blunt facial trauma. This is frequently experienced with both: Sports Related Injuries, Motor Vehicle Accidents or Blunt Facial Trauma. Of all of the bones which make up the orbit the most common bone(s) which fracture are those which comprise the Orbital Floor. Orbital Floor Facial Fractures are commonly experienced after "direct" trauma to the ocular globe (eye) as in a "Punch by a Fist", or hit in the eye with a "Baseball or Tennis Ball". When the Eye experiences a direct force, an increase in pressure in the ocular globe causes the weakest portion of the Orbital Box to Fracture and Blow Out. This is actually a developmental protection mechanism in order to protect the eye from further damage.
An Orbital Floor Blow Out Fracture is a commonly seen orbital fracture as reviewed above. This Blow Out type fracture, blows the orbital floor bones into the maxillary sinus. These boney fractures can act as a "Trap Door Deformity" in which the soft tissues of the orbit can become entrapped within this fracture site causing a decreased ability for the ocular globe to move freely. For further information of the treatment of facial fractures, review the portion on "Reconstructive Surgery" at www.plasticsurgerynewjersey.org
The diagnosis of an orbital floor and or orbital fracture is routinely documented by a CT Scan of the facial bones. Physical examination may also document an orbital floor fracture by the inability of the patient to look upward on the affected side. The treatment of orbital floor fractures is often controversial. If the fractured bony component is large or involves other facial fractures, surgical repair is often recommend. If the peri-orbital muscles or soft tissue are "entrapped" within the orbital floor fracture, surgery is often recommended. However is some cases, the surgeon may recommend that conservative therapy be implemented for a period of 1-2 weeks to allow any swelling of the peri-orbital soft tissue to resolve and then re-examine the patient.
Surgery of the orbit, orbital floor and facial bone fractures when necessary is recommended within two weeks after the initial trauma. After this time period, the bony fracture components start healing, and it may become more difficult to correct or reduce the fracture site. Often micro plates, screws, mesh and or bone grafts may be necessary to reconstruct the fracture defects, depending on the size of the bony fractures. The surgical approach to the fracture site may be through a combination of "lower eyelid" "eyebrow" or intra-oral approach.
In all cases one needs to select a surgeon who has experience and expertise in these procedures. One should select a surgeon who performs these procedures regularly not ocassionally. To review additional information concerning Dr. Stephen A. Chidyllo and his experience with the treatment of "Facial Fractures" and Orbital Fractures, please review the website at : www.plasticsurgerynewjersey.org
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Central New Jersey Plastic Surgery and Center for Advanced Reconstructive Surgery is an advanced concept in Reconstructive Plastic Surgery. Dr. Stephen A. Chidyllo, Medical Director, specializes in reconstructive surgery of the face and breasts. Dr. Stephen Chidyllo is fully trained in both Plastic Surgery and Dentistry. He is board certified in Plastic and Reconstructive surgery and the "Chief" of Plastic Surgery at Jersey Shore University Medical Center, Monmouth County New Jersey. He has completed an additional Fellowship Training in the fields of Cranio-Maxillofacial reconstructive surgery. He has been in the practice of dentistry and plastic surgery for a combination of almost 30 years. for further information concerning Dr. Stephen A. Chidyllo and Central New Jersey Plastic Surgery please review: www.plasticsurgerynewjersey.org