Surgical treatment of orbital floor fractures.

Ninety patients with orbital floor fractures were treated by the Otolaryngology Service of the Columbia-Presbyterian Medical Center. Of these 90 patients, 58 were classified as coexisting and 32 as isolated. All fractures with clinical symptoms and demonstrable x-ray evidence should be explored. Despite negative findings by routine techniques, laminography may confirm fractures in all clinically suspicious cases. In this series, 100% of the patients explored had definitive fractures. A direct infraorbital approach adequately exposes the floor of the orbit. An effective and cosmetic subtarsal incision was utilized. Implants were employed when the floor could not be anatomically reapproximated or the periorbita was destroyed.