Orbital Fracture Repairs: A 5-Year Institutional Analysis of Complications

Abstract

Objectives:

1) Analyze the complications associated with orbital fracture repair. 2) Recognize the potential benefit of an interdisciplinary approach for complicated cases.

Methods:

Five-year retrospective chart review of all orbital fractures treated at a military Level I Trauma Center from January 1, 2007, through January 1, 2012. All operative reports, inpatient and clinic notes were reviewed, and a database was created detailing patient demographics, nature of injury, and the surgical service and techniques used for each case. The otolaryngology, ophthalmology, and oral and maxillofacial surgery (OMFS) departments collaborated on the analysis of all cases and complications.

Results:

A total of 107 cases met inclusion criteria. 54 cases were treated with operative repair. The otolaryngology service performed 20 operations and had 6 complications with 3 patients requiring surgical revision. These complications included 3 cases of entropion and 3 cases of ectropion. The OMFS service performed 19 operations and had 6 complications with 4 patients requiring surgical revision. These complications included 3 cases of entropion and 5 cases of postoperative diplopia. The ophthalmology service performed 5 operations and had 1 complication of diplopia that required surgical revision. A total of 11 cases were treated by the otolaryngology and/or OMFS service in conjunction with ophthalmology as a team approach. None of these cases experienced a postoperative complication.

Conclusions:

Surgical treatment of orbital fractures can have serious complications that often require surgical revision. An interdisciplinary team approach has proved effective at our institution and should be considered for any complicated case.