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May 1988

The Temporal Approach to Impacted Lateral Orbital Wall Fractures

Author Affiliations

From the Department of Otolaryngology–Head and Neck Surgery, University of Southern California School of Medicine, Los Angeles.

Arch Otolaryngol Head Neck Surg. 1988;114(5):550-553. doi:10.1001/archotol.1988.01860170080023

• Impact forces centered over the lateral orbital rim may cause fracture dislocations of the frontal process of the zygoma and the orbital plate of the sphenoid bone. These two major components of the lateral orbital wall may be impacted separately or as a unit into the posterior orbit to cause severe injuries to the eyeball or optic nerve. These ophthalmic injuries may be worsened by attempts to manipulate the bony fragments through the standard periorbital incisions. A safer approach is the temporal approach that exposes the entire lateral zygomaticoorbital region through a hemicoronal incision. This allows for manipulation of the lateral wall fragments under direct visualization and without retraction pressure on the globe. This larger operation appears justified in selected cases by the reduced risks to an already compromised eyeball or optic nerve.

(Arch Otolaryngol Head Neck Surg 1988;114:550-553)

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