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Orbital Fractures

Dr. Zoumalan has extensive experience in managing orbital trauma and subsequent orbital fractures that can result from the trauma. Orbital fractures mainly occur from trauma such as car accidents, falls, and assaults. The orbit is a series of bones that comprise the wall (or socket) that contains the eyeball and other important contents that allow us to see and move our eye in all directions. Parts of the orbit are more prone for injury (such as the floor, which has a paper thin bone that can often break with force that usually doesn’t break other bones in the rest of the body). Such fractures may need to repaired when they result in double vision, difficulty seeing, or deformity of the socket or eye. The surgery involves exploration of the fracture and reparing it. I use various materials to repair the fracture depending on its size and patient factors. Implant materials range from titanium mesh, Medpor implants, and calvarial bone graft (bone graft taken from the calvarium or skull). Oftentimes, the orbital fractures may often involve other facial bone fractures. In such instances, I team up with a plastic surgeon skilled in facial bone fractures to address and repair all fractures.

Oftentimes in orbital trauma, the eyelid may have an injury as well. Dr. Zoumalan has extensive training in repairing the eyelid injuries as well, this is usually done at the same time if not already have been repaired beforehand.

Common Question and Answers
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    Preoperative diagnosis: Left orbital floor fracture resulting in entrapment. The left eye is unable to move upward (to look up) as seen in top left figure. This can be seen in some fractures that “trap” or restrict one of the eye muscles to appropriately allow for the eye to rotate upwards. This is an urgent issue that requires immediate repair, especially in children or teenagers. Top right photo was taken three months after repair and note that the patient is able to equally move both eyes upward without any difficulty.

    Procedure performed: Left exploration of orbita, release of the entrapped extraocular muscle, and repair of left orbital floor fracture.

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    Preoperative diagnosis: Right zygomatico-maxillary complex (ZMC) fracture, right orbital floor fracture.

    Procedure performed: Exploration and repair of the rightzygomatico-maxillary complex (ZMC) fracture and orbital floor fracture.

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    Preoperative diagnosis: Leftzygomatico-maxillary complex (ZMC) fracture, right orbital floor fracture.

    Procedure performed: Exploration and repair of the leftzygomatico-maxillary complex (ZMC) fracture and orbital floor fracture.