Orbital Trauma Reconstruction

Orbital fractures represent a large proportion of facial trauma and lead to functional and aesthetic deformities that alter a patient’s quality of life. The anatomy and pathophysiology are summarized to help guide patient management. Patient selection, along with a multidisciplinary assessment, thorough physical exam, preoperative imaging, and surgical technique, are critical for optimal outcomes. Subsequent follow-up to identify early and late complications is crucial. While fundamental concepts have historically remained the same, contemporary management of orbital fractures includes newer developments in individualized implants and instrumentation. Surgical techniques have also evolved to achieve repair through less invasive techniques. This chapter reviews the latest literature concerning orbital fractures and offers additional personal insights from the perspective of an otolaryngologist-facial plastic surgeon. The authors explore controversies and provide guidance on topics that have more than one correct answer. Overall, there are many ways of approaching orbital trauma, and decision-making should be influenced by the expertise and comfort level of the primary surgeon, in conjunction with literature-based best practices.