DR. HENAL JAVERI

, Dr. (Mrs.) KASTURI BHATTACHARJEE, DR. ADITI MEHTA, Dr. Vatsalya Venkatraman

Abstract

PURPOSE: To showcase the challenging surgical management of delayed multiple orbital fractures with lacrimal canalicular dissection and medial canthal dystopia. Two customised approaches for the repair of inferior medial canthal dystopia is also highlighted.

METHODS: Case 1 was managed with placement of a medpor-titanium-medpor implant for the inferior and medial wall fracture, via a transconjunctival approach. The canthal dystopia was corrected by simply suturing the limbs of the medial canthal tendon, individually to the medial periosteum with a good outcome. Case 2 underwent a conjunctivo dacryocystorhinostomy (CDCR) with a mucous membrane graft. Canthal fixation with titanium mesh and screws was performed. Orbital floor was repaired with a medpor implant.

RESULTS AND CONCLUSION: The structural, functional and cosmetic outcome was satisfactory.Orbital trauma can have a myriad of presentations. A tailored approach with improvisation as needed is emphasised in this video.