This report describes a combined ophthalmic and otolaryngologic procedure for early management of orbital floor fractures. The surgeons reappose the fractured orbital rim, moulding and supporting the shattered orbital floor in the desired position under direct visualization. This is made possible by simultaneous use of the Caldwell-Luc approach through the maxillary sinus and a subperiosteal exposure of the orbital floor through an incision in the infraorbital rim. The components of this procedure have been described previously, but the combined ophthalmic and otolaryngologic approach merits re-emphasis as a primary method of treatment.
The problem of orbital floor fractures and their sequelae have been described in the ophthalmic literature for at least 70 years, and the reader is referred to the papers of Lang,1 LeGrange,2 Pfeiffer,3 Smith and Regan,4 Converse and Smith,5,6 and Schjelderup7 for the development of thought concerning the mechanism of production
ABRAHAMS IW, DODD RW. Orbital Floor FracturesA Combined Procedure of Early Surgical Management. Arch Ophthalmol. 1962;68(2):159-167. doi:10.1001/archopht.1962.00960030163004