The Differences in Management of Isolated Orbital Floor Fractures

Abstract

Objective: To evaluate 1) differences in opinion between the subspecialties and surgeons from Sweden and the United States in the management of branchio-oculo-facial syndrome (BOF); 2) if the surgeons handle these cases based on their own individual criteria; 3) the correlation between the management of the patients with BOF and late sequels upon eye examination.

Method: Eleven patients with BOF were selected from the records in the Department of ENT and Head & Neck Surgery, Karolinska University Hospital. They were presented to surgeons from different countries and subspecialties who gave their opinion regarding the need for surgery and risk for late enophthalmus.

Results: In only 48% of the cases the surgeons were in agreement of the management of the patients regarding whether or not to operate. In evaluating the risk for late enophthalmus the surgeons were in agreement in 51% of the eleven cases. The surgeons from the United States found need of surgery 13% more than the surgeons from Sweden.

Conclusion: The management of BOF appears to be based on both individual and local traditions. There are considerable differences in the management of BOF, due to lack of reliable consensus. Guidelines based on randomized prospective study in BOF are required.