Orbital floor fracture.

[Rydive]

Hey everyone,

I recently posted a question on a medical/diving forum Scuba Clinic - Index in the hope of some advice. I thought I'd copy it to here in case anyone can help.

Much appreciated!

"Hi folks,

I am posting in the hope that a doctor experienced in diving or maybe somebody with personal experience might be able to give me some advice. I am about to undergo surgery due to several fractures to my cheek and to my orbital floor(bone under the eyeball). It is the reconstruction of the orbital floor that concerns me with regards to diving, as I'm sure all the doctors here are aware that the orbital floor forms the roof of the Maxilla sinus. What concerns me is that if the fracture is not repaired properly I will be liable to force air in to the orbit when clearing my ears... how likely is this? Is there anything that I should specifically ask the surgeon to consider? I have been told that the two common techniques are the use of a mesh or a bone graft. It has been hinted that the bone graft is the more "air tight" of the two methods; anybody know anything about either technique?

I am due to see the Max Fax surgeon again this Wednesday (12th Dec) and the operation will be soon after, any help before then would be really, really appreciated. I feel like I need to get this right as there is zero chance of me going back for a second go.

Many thanks in advance,

Ryan."

[triplefin]

try these as well - the boards are frequented by diving docs

Scubadoc's Diving Medicine

Scuba Clinic - Index

read about your 'incident' on CA - hope you manage to get sorted over the winter and back in the water next year

[Rydive]

Thanks! Great blog by the way.

[Helen F H]

If i remember rightly there is a case study on something similar in my scuba and subaquatic medicine book - however me and said book are currently a couple of hundred miles apart I will be back up there next weekend and will have a look for you and report back. From what i remember a diver had a previous facial/sinus fracture and air had leaked into the area around the eye making it very swolen and deformed.

[Rydive]

Originally Posted by Helen F H

If i remember rightly there is a case study on something similar in my scuba and subaquatic medicine book - however me and said book are currently a couple of hundred miles apart I will be back up there next weekend and will have a look for you and report back. From what i remember a diver had a previous facial/sinus fracture and air had leaked into the area around the eye making it very swolen and deformed.

Hi Helen, yes, that's the sort of thing I'm afraid of. They can repair the fracture, but obviously they need to get it air tight to stop what you describe from happening. If that happens then it would spell the end of my diving career before it's really began.

I can imagine that even a miniscule amount of air leaking in to the eye socket at depth would cteate a VERY unconfortable ascent as the air expands. That's why I want to find out a bit more about the different techniques for repair, so that I get the right one.

Thanks for your help,

[Lou]

I am not sure that it would be a problem as there is obviously some sort of small leak there under normal circumstances. Meet me in a pool and I will prove it to you I can clear my ears by forcing air and watch a small stream of bubbles be emitted from my eye socket, around the tear duct area.

Well worth asking the question face to face with a doctor suitably qualified, and not a bunch of eejits like us off t'interweb, but my feeling would be that any air that moves into that area could escape so no big deal.

fingers crossed for you anyway.

Lou

[David Tombs]

Lou are you sure its not actually from your tear duct? Thats a common phenomina,fissure's from the Maxillary sinus however arn't.

[angleseydiver]

Try working on it with an Orbital Sander...


... yep... I know where my coat is...

[Rydive]

Originally Posted by angleseydiver

Try working on it with an Orbital Sander...


... yep... I know where my coat is...

Pure comedy genius!

In response to Lou, I think that as David suggested the bubbles you are seeing are not from behind the eyeball... and are therefore not a bona fide "eye fart". They are most likely coming from the tear duct.

I have and will be speaking to the surgeons about all this, I just wondered if there was anybody here with both medical and diving experience, or personal experience that might be able to offer any suggestions.

[Lou]

I have no idea, to be honest. Hence don't take medical advice from us lot!

How does the air get fromthe sinus into the tear duct, David? I am intrigued now as to how my party trick works. I have made a child cry by showing them it once, so it does have its uses.....