Original Article

The significance of orbital floor exploration during open reduction of zygomaticomaxillary complex fractures

Christos Krasadakis¹, Dimosthenis Igoumenakis², Ourania Schoinohoriti¹, Constantinos Mourouzis¹, Georgios Rallis¹

1. Department of Oral and Maxillofacial Surgery, KAT General Hospital of Athens, Greece
2. Department of Oral and Maxillofacial Surgery, Venizeleio General Hospital of Heraklion, Crete, Greece

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Keywords: Zygomaticomaxillary complex fractures, ZMC, Open reduction, Orbital floor defects, Reconstruction

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Abstract

Objective: Zygomaticomaxillary complex (ZMC) fractures represent a common type of facial fractures, sometimes associated with defects of the orbital floor that may escape diagnosis, unless investigated intraoperatively following open reduction. The aim of the study was to determine the frequency of orbital floor defects among cases of ZMC fractures treated with open reduction in our Department and to share our experience in the diagnostic and therapeutic approach of such defects. Patients and methods: The files of all patients, treated in our Department for ZMC fractures from January 2010 to October 2014 were retrieved and reviewed retrospectively. Specific related data were registered and submitted to thorough analysis. Results: Based on our findings a considerable percentage (34.1%) of the patients with ZMC fractures demonstrated considerable defects of the orbital floor; these were diagnosed through intraoperative exploration of the orbital floor following open reduction of the fractures and appropriately treated. Conclusions: Orbital floor defects associated with ZMC fractures may remain undiagnosed and therefore untreated, unless routine exploration of the orbital floor is performed following open reduction of the fractures. This could result in severe morbidity, including enofthalmos, restricted ocular mobility and impaired visual acuity.

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