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Objective: To evaluate the incidence and evolution of diplopia as a complication of orbital fractures in adults., Patients and Methods: A review was conducted on medical records of all consecutive adults with orbital fracture referred between January 2014 and December 2015. An analysis was made of the incidence of diplopia secondary to fracture in the acute phase and its evolution. A descriptive study was performed on the variables related to patients, fractures, and fracture and diplopia treatment., Results: The study included 39patients with a mean age of 48years (17-85). Of all the patients, 17 (43.6%) presented with diplopia in the acute phase. Differences were found between the groups with and without diplopia in relation to muscle entrapment diagnosed by orbital computed tomography, duction limitation, and fracture surgery ≤1week (P=.02, P=.00, P=.04, respectively). Out of the 17patients with diplopia, 12 had a mean follow-up of 18weeks (1-72), and in 10 (83.3%) diplopia was resolved in a mean time of 10weeks (1-72). There were spontaneous resolution in 4 (33.3%) patients, and resolution after fracture surgery in 4 (57%) of the 7 that underwent surgery. In 4cases (33.3%) prisms were prescribed, and 2 (16.6%) required strabismus surgery., Conclusions: Diplopia secondary to orbital fracture in adults is frequent, but it is resolved in most cases spontaneously or after fracture surgery. A few patients will require prisms and/or strabismus surgery., (Copyright © 2017 Sociedad Española de Oftalmología. Publicado por Elsevier España, S.L.U. All rights reserved.)

Background: The management of orbitary fractures is one of the most challenging in facial trauma; the variety of reconstruction materials for its treatment is broad and is constantly improving, but despite this there is no consensus for its use or literature that sustains it., Objective: To present the use and design of a preformed bone implant as an alternative for the reconstruction of orbital floor fractures in the pediatric age group., Clinical Case: A 7-year old male who suffered a right hemifacial contusion trauma with clinical and tomographic diagnosis of right pure blowout type orbital floor fracture with inferior rectus muscle entrapment and right post-traumatic palpebral ptosis. Successful surgical reconstruction was performed 7 days later with a pre-constructed bone cement implant. Eight weeks after surgery the patient presented with mild residual palpebral ptosis, no ocular movement limitations and no diplopia., Conclusions: The use of a bone cement implant can be considered appropriate for the reconstruction of these fractures, as another alternative to be used by the ophthalmologist among the variety of all the other materials used for this purpose. We consider that our optimism based on the results obtained in this case obligates us to increase the number of patients treated in order to gather more evidence and do larger follow up., (Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)

Background: Silent sinus or imploding antrum syndrome is a very rare condition, consisting of a usually asymptomatic spontaneous collapse of the sinus walls and floor of the orbit. It is associated with negative pressures, and when this occurs, it presents with manifestations such as enophthalmos, hypoglobus, and tilt flow orbital floor. As its incidence is very low, it is frequently missed as a diagnosis, and in fact there are currently fewer than 150 cases reported in the literature., Clinical Cases: Three patients have been identified in our practice over a period of two years, with different symptoms that influenced the decision of the treatment modality, which were: watch and wait, endoscopic sinus surgery, or endoscopic sinus surgery plus orbitoplasty., Conclusions: Despite being a rare entity, it stills catches the attention of the ENT, OMF surgery and Ophthalmologist. The diagnosis is mainly radiological, due to the late clinical manifestations and symptomatology. The treatment should be individualised and based on the symptoms and the individual decision of each patient, firstly by Functional Endoscopic sinus surgery, and once sinus permeability is restored, it may require augmentation surgery of the orbital floor, either with autologous bone implant, titanium or other material. It is important to be aware of this pathology, to know and to suspect it, avoiding misdiagnosis., (Copyright © 2016 Academia Mexicana de Cirugía A.C. Publicado por Masson Doyma México S.A. All rights reserved.)

Objectives: Orbital emphysema, or the presence of air in orbital tissues, is normally associated with an injury although it can arise when a Valsalva maneuver causes an increase in upper airway pressure. This potential complication of an orbital wall fracture, usually in the ethmoid bone, occurs in 50% of such cases. On fracture, air passes from the nasal fossa, sinuses, or subcutaneous tissue. The condition is benign and transient in most cases, and loss of vision is rare. No protocol for treating orbital emphysema with serious complications in which vision is affected has been established. We report 9 cases of orbital emphysema, describing events leading to the fractures, radiologic findings, and treatments.

Purpose: We present a case of traumatic luxation of the ocular globe into the maxillary sinus., Material and Methods: Male patient, 23 years old with orbito-facial trauma and traumatic luxation of his right ocular globe into the maxillary sinus., Conclusion: To present an unusual case of traumatic prolapse of an undamaged ocular globe into a paranasal sinus.

From 1976 to 1988 346 fractures of the orbital floor were repositioned in the ENT-Department of the University of Mainz. 145 (41.9%) cases were pure orbital fractures, in 201 (58.1%) cases the fractures were extended. Assaults followed by accidents were the most frequent causes of injury. Preoperatively, diplopia and enophtalmus were among the most frequent symptoms, followed by fracture of the orbital rim, parestesias or anestesias of the infraorbital nerve and limitation of ocular motility. A support of the orbital floor was necessary in 122 (32.7%) of the cases, which was achieved by a modified vesical Foley catheter. In 194 (56.1%) patients lyofilized dura was used to cover the repositioned bone fragments. The orbital floor had to be reconstructed in 37 cases (10.7%) with autologue cartilage or bone. Supplementary wiring was necessary in 95 (27.5%) cases. In the follow up, diplopia and alterations of the infraorbital nerve were studied. 176 (50.8%) of the patients had diplopia with or without alterations of ocular motility, which was confirmed by routinely performed explorations in the Department of Ophthalmology. In 24 (6.9%) cases light alterations of ocular motility persisted six months postoperatively. 113 (32.7%) patients referred parestesias of the infraorbital region, persisting in 40 (11.6%) patients for at least six months.