Evaluation by plain film radiography is often inadequate and more sophisticated studies are helpful, especially computerized axial and coronal tomography. In the final analysis, in most cases involving appreciable disruptions and displacements, accurate assessment and optimal repair are most often achieved by open exploration. Stenting of nasolacrimal duct injuries with silicone tubing. Although uncommon in injuries of the face, direct trauma and fracturing into the orbit may produce hemorrhaging and encystation of blood or an extension of the fracture into the superior orbital fissure, impairing or directly traumatizing the III, IV, and VI cranial nerves Which course through this fissure, resulting in ophthalmoplegia, ptosis of the lid, proptosis, and a fixed and dilated pupil. In most instances, the treatment of choice is conservative.
Ophthalmological consultation is indicated, and occasionally decompression is performed.
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