ORBITAL FLOOR RECONSTRUCTION: A COMPREHENSIVE REVIEW OF SURGICAL APPROACHES AND RECONSTRUCTIVE MATERIALS

Orbital floor fractures are common components of midfacial trauma and may produce diplopia, enophthalmos, ocular motility disturbance, infraorbital sensory change, and aesthetic deformity when orbital volume and wall anatomy are not adequately restored. Orbital floor reconstruction therefore requires integration of clinical findings, computed tomography, fracture morphology, timing of intervention, surgical access, and implant selection. This narrative review synthesizes the principal concepts contained in a comprehensive dissertation on orbital floor reconstruction, including orbital anatomy and biomechanics, fracture classification and mechanisms, clinical and radiological assessment, indications and timing of repair, surgical approaches, reconstructive biomaterials, postoperative care, complications, and recent digital advances. The review emphasizes that clinical examination remains central to treatment planning, while computed tomography defines defect morphology, herniation, associated wall involvement, and the three-dimensional reconstructive target. Transconjunctival, transcutaneous, transantral, endoscopic, and combined approaches each have specific indications and morbidity profiles. Autogenous grafts, titanium, porous polyethylene, resorbable polymers, and customized implants remain important reconstructive options. Contemporary computer-assisted planning, patient-specific implants, navigation, and three-dimensional printing may improve geometric accuracy in selected complex, comminuted, delayed, or secondary reconstructions, although cost, workflow, technical expertise, and heterogeneous evidence remain relevant limitations. Successful reconstruction is therefore based on restoration of orbital boundaries and volume while preserving ocular function and minimizing surgical morbidity.