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An orbital blowout fracture is a traumatic deformity of the orbital floor or medial wall that typically results from the impact of a blunt object larger than the orbital aperture, or eye socket. [1] Most commonly this results in a herniation of orbital contents through the orbital fractures. [ 1 ]
The zygomaticomaxillary complex fracture, also known as a quadripod fracture, quadramalar fracture, and formerly referred to as a tripod fracture or trimalar fracture, has four components, three of which are directly related to connections between the zygoma and the face, and the fourth being the orbital floor.
The floor (inferior wall) is formed by the orbital surface of maxilla, the orbital surface of zygomatic bone and the minute orbital process of palatine bone. Medially, near the orbital margin, is located the groove for nasolacrimal duct. Near the middle of the floor, located infraorbital groove, which leads to the infraorbital foramen.
medial: perpendicular plate of the palatine bone and its orbital and sphenoidal processes; lateral: pterygomaxillary fissure; inferior: part of the floor is formed by the pyramidal process of the palatine bone.
Möbius (left) and Hückel (right) orbital arrays. The two orbital arrays in Figure 3 are just examples and do not correspond to real systems. In inspecting the Möbius one on the left, plus–minus overlaps are seen between orbital pairs 2-3, 3-4, 4-5, 5-6, and 6-1, corresponding to an odd number (5), as required by a Möbius system.
The infratemporal fossa is an irregularly shaped cavity that is a part of the skull.It is situated below and medial to the zygomatic arch.It is not fully enclosed by bone in all directions.
Incision lines for blepharoplasty. The thorough pre-operative medical and surgical histories, and the physical examination of the patient's periorbital area (eyebrow-to-cheek-to-nose), determine if the patient can safely undergo a blepharoplasty procedure to feasibly resolve (correct or modify, or both) the functional and aesthetic indications presented by the patient.
The second stage, if needed, involves reconstruction of the orbital floor. While some clinics perform the two stages simultaneously, [ 13 ] [ 14 ] [ 15 ] most authorities recommend waiting a minimum of 6 or as many as 18 months, as spontaneous remodeling of the orbital floor after the sinus repair will occur in many if not most cases.