Orbital floor reconstruction in facial asymmetry: a clinical case

Orbital floor blowout fractures may cause severe facial asymmetry, particularly when combined with panfacial fractures with wide bone defects. Surgical repair recommendations depend on multi-disciplinary clinical evaluation and digital imaging to assess the amount of soft tissues herniation, the infraorbital nerve and rectum inferioris muscle entrapments, the ocular bulbus dislocation, and the ocular diplopia. A second surgery intervention may be required particularly when the orbital floor fracture is combined with skull and panfacial fractures in severely traumatized patients when the first surgical stage has been focused more on life saving than on craniofacial reconstruction. Preoperative multiplanar CT scans with 3D image reconstructions permit 3D printing modelling to achieve useful guide datas to combine bone grafts and titanium meshes in an effective and low expensive technique for orbital floor reconstruction when severe facial asymmetry occurs.