Orbital Fracture with Numbness

I am 25 and was hit with a blunt force 8 days ago around my left eye.  The only symptom I have from it still is numbness in my left lip, teeth, nose and cheek.  I had a CT done and I have a fracture in the lower orbital wall and it looks like there is some kind of discharge about the size of a pea.  What are the chances this will heal on its own?  Is it worth surgery?  I can live with the numbness but I don't want to loose any muscle tone/control or have sunken eye.  I don't have these sysmptoms now but can they appear in the future?  Please Help!

[John C Hagan III, MD, FACS, FAAO]

If you are not having double vision and if the eye is not already sunk back in your head and the CT does not show a very large displaced floor fracture most surgeons would advise observation but not surgery. In most instances the numbness goes away after weeks to months.

Surgery is not without risks including that it can cause double vision or make it worse, it often makes the numbness worse, the eye can still sink back or it can be pushed out too far plus the regular risks of infection, bleeding and damage to eye.

Be aware that these types of injuries are often managed by different types of surgeons including plastic surgeons, ophthalmologists, ENT surgeons and oral surgeons. The plastic surgeons by far operate on many more patients than the ophthalmologists.

I would suggest you get a second opinion from an ENT or Eye MD oculo-plastic surgeon if you are currently seeing a plastic surgeon.

Ask your family MD to help you set up a second opinion.

JCH III MD

[sbeck]

Thank you for your advise.  I really appreciate your help.