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The article by Silver et al is important because of the potentially devastating complication it considers, severe orbital infection as a complication of orbital fracture. While it is surprising that this complication does not occur more commonly, this probably reflects the usual integrity of the periorbita and its excellent blood supply presenting a barrier to infection.
The authors raise two questions: (1) Are severe orbital infections a "frequent" (reviewer's quotes, but not defined by authors) sequela of orbital fractures that are secondary to blunt trauma? And, if so, are there certain patients at increased risk? (2) In the nonsurgical management of orbital fractures secondary to blunt facial trauma, can orbital infections be prevented and can antibiotic prophylaxis assume a role? A retrospective chart review was accomplished, focusing on postorbital septal infections, defining these as "severe" infections presenting shortly after fracture of the orbit secondary to blunt trauma. Three cases See
Silver HS, Fucci MJ, Flanagan JC, Lowry LD, Jafek BW. Severe Orbital Infection as a Complication of Orbital Fracture. Arch Otolaryngol Head Neck Surg. 1992;118(8):882. doi:10.1001/archotol.1992.01880080104023