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Letter to the Editor| Volume 58, ISSUE 2, P245, February 2020

Orbital floor and wall as a biological “crumple zone”

Published:January 13, 2020DOI:https://doi.org/10.1016/j.bjoms.2020.01.001
      We write about an interesting article by Zaggut et al
      • Zaggut A.
      • Perry M.
      Do orbital floor plates adequately protect against serious secondary injury?.
      , that was published in your journal. We wondered what the authors’ opinions are regarding the concept of the thin orbital floor and medial orbital wall being akin to a biological orbital “crumple zone.” The orbit has a pyramidal shape with a wide base and narrow apex.
      • Dutton J.J.
      Atlas of Clinical and Surgical Orbital anatomy.
      Ordinarily, forcing the globe into the orbit would increase orbital pressure as the globe moves posteriorly into a smaller space. Subsequently, the medial orbital wall or orbital floor would preferentially fracture before the intraocular pressure increased to levels that might cause the globe to rupture. As recommended by the authors, fixation for second-time orbital fracture repair may preclude this evolutionary and protective anatomical mechanism.
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      References

        • Zaggut A.
        • Perry M.
        Do orbital floor plates adequately protect against serious secondary injury?.
        Br J Oral Maxillofac Surg. 2019; 57: 539-542
        • Dutton J.J.
        Atlas of Clinical and Surgical Orbital anatomy.
        2nd ed. Elsevier Saunders, 2011