A fracture of the orbital roof is usually mixed with other injuries, including fracture of the frontal sinus and intracranial injury.


Occurrence: may follow impacts with moderate to high energy


Clinical features:

(1) diplopia or restricted up-gaze

(2) ptosis

(3) epistaxis

(4) CSF rhinorrhea

(5) anosmia

(6) depression of the supraorbital rim

(7) decreased sensation or numbness (hypesthesia) of Cranial Nerve V1 (supraorbital)

(8) displacement of the globe down (hypo-ophthalmos) or out (pulsatile exophthalmos)


Indications for surgical correction:

(1) depressed skull fracture

(2) significant diplopia

(3) significant exophthalmos

(4) fracture of the frontal sinus affecting the nasofrontal duct


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