Thesis (M.Sc.) - Cairo University - Faculty of Oral and Dental Medicine - Department of Oral and Maxillofacial Surgery

Purpose: To compare between patient with orbital floor Blowout fracture in literature that has been managed conservatively versus the surgical management using Titanium meshes and Autogenous bone grafts including Cranial, Iliac and Mandibular bone grafts in concern to Diplopia, Ocular motility defect and Enophthalmos to develop a guidelines for Orbital blow out management. Results: A total of 20 Articles were obtained, 3 articles were mainly involving conservative management and 17 Articles were mainly involving surgical management. 9 articles mainly involving Titanium Meshes and 8 articles mainly involving autogenous bone graft. 2 Articles were involving cranial bone graft, 3 were mainly involving iliac bone graft and another 3 articles were mainly involving mandibular bone graft. The total 20 articles included 529 patients, 135 were treated conservatively and 394 were treated surgically. In the conservative group out of the 135 patients 42 (31.11%) had diplopia on presentation where 32 patients has underwent spontaneous resolution and only 10 (7.4%) patients still have diplopia, 53 (39.25%) patients had ocular motility defect on presentation 28 patient underwent spontaneous resolution and 25 (18.51%) patients still suffer from motility defects and 11 (8.14%) patients suffer from late enophthalmos. In the Surgical group has 394 patient, 154 (39.08%) patients were presented with diplopia at the initial examination these number was reduced to 34 (8.6%) patients post operatively, also 100 (25.38%) patients suffered from enophthalmos at presentation these number was reduced to 42 (10.65%) patients even though proper orbital volume was restored and mentioned in the articles (Orbital volume change between the uninjured and repaired side was ranging from 0.08 and 0.540 cc)

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