A common orbital floor fracture repair with implants at surgery center facility in California includes
| |
Units |
Avg Cash price |
Provider |
Ophthalmologist visit provider fee
First-time visit
Standard
|
1 |
$135 |
Provider fee to repair blowout fracture in eye socket bone
with implant
Standard
|
1 |
$1,203 |
Facility |
Surgery center fee to repair blowout fracture in eye socket bone
Standard
Standard
|
1 |
$3,259 |
Imaging |
Radiology fee for facial bone x-ray
Standard
Standard
|
1 |
$63 |
Prescriptions |
HYDROCODONE-ACETAMINOPHEN
Standard
Standard
|
30 |
$18 |
Equipment |
Implantable/insertable device
Standard
Standard
|
1 |
$3,091 |
Anesthesia |
Anesthesiologist fee to be "put under" for procedure
Level 4
Standard
|
1 |
$312 |
Anesthesiologist time to be "put under" for procedure
Per minute
Standard
|
346 |
$803 |
Total average cash price |
|
A common orbital floor fracture repair with implants at outpatient hospital facility in California includes
| |
Units |
Avg Cash price |
Provider |
Ophthalmologist visit provider fee
First-time visit
Standard
|
1 |
$135 |
Provider fee to repair blowout fracture in eye socket bone
with implant
Standard
|
1 |
$1,203 |
Facility |
Outpatient Hospital fee to repair blowout fracture in eye socket bone
level 5
Standard
|
1 |
$7,035 |
Imaging |
Radiology fee for facial bone x-ray
Standard
Standard
|
1 |
$63 |
Prescriptions |
HYDROCODONE-ACETAMINOPHEN
Standard
Standard
|
30 |
$18 |
Equipment |
Implantable/insertable device
Standard
Standard
|
1 |
$3,091 |
Anesthesia |
Anesthesiologist fee to be "put under" for procedure
Level 4
Standard
|
1 |
$312 |
Anesthesiologist time to be "put under" for procedure
Per minute
Standard
|
346 |
$803 |
Total average cash price |
|
An orbital floor is the bony lower part of the eye socket that functions as the roof of the maxillary sinus. The orbital floor is actually made up of three bones: the maxillary bone, the palatine bone, and the orbital plate of the zygomatic bone. Facial bones are small, complex, and delicate. An orbital floor fracture most commonly occurs from blunt trauma or a hit. Orbital floor fractures are common; about 10% of all facial fractures include the orbital floor.
Sometimes orbital fractures heal on their own, with no lasting damage to the surrounding structures or the eye itself. Typically after a traumatic facial injury and orbital fracture, the orbital area may have significant swelling. This may cause conditions like double vision, reduced eye mobility, reduced vision due to swelling of the surrounding tissue, and pain. As the swelling goes down, these conditions will either stay the same or improve. This is one indicator that is used to determine the need for surgery.
While some guidelines vary, literature states that in the absence of disabling factors such as bleeding, instability of the eye itself, or risk of permanent damage, it is prudent to wait about 14 days before determining if surgery is needed. This gives the fractured area time for the swelling to go down and time to see if symptoms resolve on their own.
Once improvement stops, it is time to decide if surgery will be needed.
When an orbital floor fracture is causing problems with vision or with physical functioning of the eye structures, then surgery is warranted.
The clinical indications for surgery are:
· Dipoplia - double vision
· Extraocular muscle entrapment – muscle is stuck in the fracture line, restricting eye muscle movement.
· Large fracture - greater than 50% of the area
· Enophthalmos greater than 2 mm – eye is pushed inward.
When repairing an orbital floor, which is a very thin juncture of bones, a material is used to cover the defect, called an implant. Physicians have several decisions about what materials to use, based on availability, the best material for the job, risk factors, and infection rates.
Implant materials used for repair come in three categories:
Autologous materials – these are implants from the patient’s own body, such as bone grafts.
Allogenic materials – implants from other donors, such as bone and cartilage tissue.
Alloplastic materials – the use of synthetic materials for repairs, such as metals, resorbable materials, and different mesh and sheet materials.
The actual orbital floor repair procedure includes some or all of the following steps:
1. Exposing the fracture site via surgical incision
2. Freeing any prolapsed muscle or other tissue that is in the fracture site
3. Re-joining the orbital wall and adding support, usually with an implant.
4. Closing the incision.
Titanium mesh has become a common material used in implants. Using this alloplastic material reduces the need for bone grafts and other types of natural materials. A study from the Journal of Cranio-maxillofacial Trauma explored the course of treatment for orbital floor fracture patients using titanium mesh. The study showed good results from the titanium, concluding that “Titanium mesh implants are a simple and reliable option for orbital floor repair.”
Another later study followed titanium mesh patients throughout the recovery period and concluded that titanium mesh is a suitable material for the reconstruction of orbital fractures. Few complications were noted, and those were mainly due to difficulties in restoring anatomy and volume.
The facial and eye areas are full of nerves, which unfortunately means that orbital fractures result in moderate to severe pain. After life-threatening injuries are ruled out, orbital fracture patients will need pain control and management. Cold compresses, anti-inflammatory medications, and pain medication may be used. During orbital fracture surgery, general anesthesia is used, as well as an anesthetic nerve block that paralyzes the eye muscles and numbs the affected side of the face.
After surgery, the anesthetic will gradually wear off, making pain medication likely. Controlling the swelling with positioning, cold, and anti-inflammatory medications also helps.
Depending on the surgical repair material used, patients can usually resume normal activities within about three weeks after surgery. Orbital floor strength is mostly regained within 24 hours after the repair. During the recovery period, patients should avoid high-impact activities or risky sports that could result in a re-fracture of the area.
In conclusion, orbital fractures are quite common since the bones making up the orbit floor are quite thin and fragile. Some fractures heal on their own, but others require surgery with implants. Several types of implants are available, including titanium mesh. Orbital repair surgery is a short procedure with few side effects, and patients usually recover quickly.
About the orbital floor fracture repair with implants Average Cash Prices
This procedure is most commonly performed at either a surgery center or an outpatient hospital.
Surgery centers, also known as ambulatory surgery centers (ASCs), are independent, licensed medical
facilities that are governed by distinct regulatory requirements compared with a hospital. Procedures
performed at an ASCs are often less expensive than when they are performed at an outpatient hospital,
but they typically offer fewer complimentary services, and may not have the full-range of support
services that a hospital provides.
Outpatient facilities are outpatient departments or clinics that may be within or next to a hospital,
but is owned and run by the affiliated hospital. These facilities can perform surgical treatments and
procedures that do not require an overnight stay. Procedures performed at an outpatient hospital are
often more expensive than when they are performed in an ambulatory surgery center, but outpatient
hospitals may offer more complimentary and support services for patients because they are connected to
the hospital system.
