BlowoutFrakturen

Blowoutfrakturen are a type of orbital fracture, specifically involving the thin orbital floor or medial wall of the eye socket. They occur when a sudden increase in intraorbital pressure causes a section of the orbital bone to fracture and prolapse into an adjacent sinus cavity, most commonly the maxillary sinus. Direct impact to the eye, such as from a fist or a ball, is a common cause.

Symptoms can vary but often include diplopia, particularly when looking upwards, due to the trapping of the inferior rectus muscle. Enophthalmos, or the sinking of the eyeball into the socket, can also occur as orbital fat herniates into the sinus. Pain, swelling, and limited eye movement are also frequent complaints. Anesthesia or paresthesia of the infraorbital nerve, which runs through the orbital floor, can lead to numbness in the cheek, upper lip, and gums.

Diagnosis is typically made through clinical examination and imaging studies, most importantly computed tomography (CT) scans, which clearly delineate the fracture fragments and any herniated orbital contents. Treatment depends on the severity of the fracture and the presence of symptoms. Small, non-displaced fractures causing no significant entrapment or cosmetic deformity may be managed conservatively with observation and symptomatic relief. Larger, displaced fractures, or those with evidence of muscle entrapment or significant enophthalmos, usually require surgical intervention to reconstruct the orbital floor and release any trapped tissues. Surgical outcomes are generally good, but complications such as persistent diplopia, restricted eye movement, or chronic pain can occur.