[Traumatology of the midface--diagnostic and therapeutic guidelines for the practicing ENT physician from the viewpoint of the ophthalmologist].

Fractures of the midface combined with orbital injuries endanger vision, binocular vision, and the lacrimal system. The best results of primary surgical management are advised if the surgeon adheres to a strict time schedule. For example, a perforating injury of the eye must be diagnosed as early as possible, and be repaired immediately. Otherwise, all manipulations necessary for reconstruction of the bone and soft tissue of the face worsen the condition of the opened eyeball, including loss of its contents and function. On the other hand, competent repair of the lacrimal system may be done at the end of the operation, and management of disordered eye mobility as seen in the "blow-out" fracture may sometimes be postponed for days or even weeks. The optimal chronological order of diagnostic and surgical management as seen from the ophthalmologist's view is given in tables, and discussed in detail.