21386 Open treatment of orbital floor blowout fracture; periorbital approach

Name of the Procedure:

Open Treatment of Orbital Floor Blowout Fracture; Periorbital Approach

Summary

This is a surgical procedure to repair fractures of the orbital floor, which is part of the eye socket. The surgery is done through an incision around the eye area to access and fix the broken bones.

Purpose

This procedure addresses fractures of the orbital floor, often caused by trauma to the face. The goals are to restore normal anatomy, improve eye function, relieve pain, and correct any cosmetic deformities.

Indications

• Sudden trauma to the face resulting in a broken orbital floor
• Double vision (diplopia)
• Sunken eyeball (enophthalmos)
• Restricted eye movement
• Significant swelling or bruising around the eye

Preparation

• Fasting for at least 6-8 hours prior to the surgery
• Stopping certain medications, as directed by the doctor
• Undergoing preoperative imaging studies like CT scans to assess the extent of the fracture

Procedure Description

1. The patient is administered general anesthesia.
2. An incision is made in the periorbital region (around the eye).
3. The surgeon carefully exposes the fractured area.
4. Fractured bone fragments are repositioned or removed.
5. Synthetic materials or bone grafts may be used to reconstruct the orbital floor.
6. The incision is closed with sutures.
7. A drainage tube may be placed to prevent fluid accumulation.

Duration

Approximately 1-2 hours.

Setting

The procedure is typically performed in a hospital operating room or a specialized surgical center.

Personnel

• Surgeons specialized in maxillofacial or ophthalmic surgery
• Nurses
• Anesthesiologists
• Surgical assistants

Risks and Complications

• Infection
• Bleeding
• Scar formation
• Vision changes
• Temporary or permanent numbness around the eye
• Displacement of the eye or recurrent enophthalmos
• Anesthesia-related risks

Benefits

• Correction of the eye socket anatomy
• Improved eye function and mobility
• Pain relief
• Improved cosmetic appearance
• These benefits can often be realized within a few weeks post-surgery.

Recovery

• Use of cold compresses to reduce swelling.
• Prescribed pain medications.
• Avoiding activities that can strain the eyes or face.
• Follow-up appointments to monitor healing.
• Sutures are typically removed after about a week.
• Full recovery takes about 4-6 weeks.

Alternatives

• Conservative management with observation for minor fractures
• Reduction surgery via transconjunctival approach
• Each alternative has varying degrees of invasiveness and effectiveness.

Patient Experience

• Postoperative pain can be managed with medications.
• Swelling and bruising around the eye are common but typically subside within a couple of weeks.
• Instructions for eye care and hygiene must be strictly followed to prevent infection.
• Regular follow-up visits are important to ensure proper healing.