The case of a symptomatic persistent orbitalndash;antral fistula after silicone orbital floor reconstruction is presented. Intermittent diplopia with Valsalva maneuvers was the patient's chief complaint. Periorbital cellulitis was a suspected complication of the fistula. This case emphasizes the importance of an often overlooked goal of orbital floor reconstruction, that is, isolation of the orbital cavity from the maxillary sinus. Greater care in positioning alloplastic implants may improve their function. Autogenous materials may be superior in orbital floor reconstruction.
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