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Enophthalmos

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https://www.readbyqxmd.com/read/28038883/orbital-fracture-repair-outcomes-with-preformed-titanium-mesh-implants-and-comparison-to-porous-polyethylene-coated-titanium-sheets
#1
Michelle Y Peng, Shannath L Merbs, Michael P Grant, Nicholas R Mahoney
BACKGROUND: Restoration of orbital volume after internal orbital fractures can prevent enophthalmos. A variety of allografts are commonly used including titanium mesh with and without porous polyethylene coating. Some controversy exists over the use of uncoated titanium mesh in the orbit. Newer products contoured to the three dimensional orbital anatomy aim to improve reestablishment of the complex orbital shape though studies of outcomes with their use are limited. METHODS: A retrospective chart review was performed to evaluate surgical outcomes in all patients who underwent orbital fracture repair with DePuy/Synthes titanium MatrixMIDFACE prefabricated implants (PFTi) as compared with porous polyethylene/titanium hybrid implants (PPETi) including Stryker Medpor Titan, MTB, and BTB implants...
December 3, 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/28027179/sliced-costochondral-chip-grafts-in-posttraumatic-enophthalmos-correction
#2
Tae-Hoon Kim, Ie-Hyon Park, Sa-Hyeok Hong, Seok-Chan Eun
BACKGROUND: Posttraumatic enophthalmos is a relatively common problem following orbitozygomatic fractures. However, inadequate long-term results are frequently observed due to the difficulty of performing intraoperative fine adjustments to soft-tissue volume and orbital size and gradual absorption of some grafted materials. Here, the authors describe an efficient method of enophthalmos correction using sliced costochondral bone and cartilage combination grafts. METHODS: From 2005 to 2011, the authors corrected enophthalmos in 12 patients using sliced costochondral grafts...
December 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28018441/a-neonate-with-joubert-syndrome-presenting-with-symptoms-of-horner-syndrome
#3
Narae Lee, Sang-Ook Nam, Young Mi Kim, Yun-Jin Lee
Joubert syndrome (JS) is characterized by the "molar tooth sign" (MTS) with cerebellar vermis agenesis, episodic hyperpnea, abnormal eye movements, and hypotonia. Ocular and oculomotor abnormalities have been observed; however, Horner syndrome (HS) has not been documented in children with JS. We present the case of a 2-month-old boy having ocular abnormalities with bilateral nystagmus, left-dominant bilateral ptosis, and unilateral miosis and enophthalmos of the left eye, which were compatible with HS. Brain magnetic resonance imaging (MRI) revealed the presence of the MTS...
November 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/28005760/can-a-specific-computed-tomography-based-assessment-predict-the-ophthalmological-outcome-in-pure-orbital-floor-blowout-fractures
#4
Stéphane Bruneau, Raoul De Haller, Delphine S Courvoisier, Paolo Scolozzi
The aim of this study was to determine the predictive value of a specific computed tomography (CT)-based assessment for the final functional ophthalmological outcome in pure orbital floor blowout fractures. Data of 34 consecutive patients with pure blowout fractures who had undergone a period of at least 6 months of medical and ophthalmological follow-up were analyzed. The following 3 CT scan-based parameters were included: area ratio of the fractured orbital floor (RF), maximum height of periorbital tissue herniation (MH), and a 4-grade muscular subscore (MSS) describing the inferior rectus muscle displacement relative to the orbital floor level...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005751/postoperative-improvement-of-diplopia-and-extraocular-muscle-movement-in-patients-with-reconstructive-surgeries-for-orbital-floor-fractures
#5
Shao-Rui Liu, Xue-Fei Song, Zheng-Kang Li, Qin Shen, Xian-Qun Fan
OBJECTIVE: With orbital floor fracture incidence rates increasing year by year, many patients require surgical treatment to improve diplopia, limitation of extraocular muscle movement (EOM), enophthalmos, and midface appearance. With the use of high-density polyethylene, titanium screws, titanium plate, and titanium mesh to repair an orbital floor fracture, enophthalmos and midfacial deformity correction procedures have made great progress. However, attenuating diplopia and the limitation of EOM are still difficult problems to prevent...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/28005746/customized-orbital-wall-reconstruction-using-three-dimensionally-printed-rapid-prototype-model-in-patients-with-orbital-wall-fracture
#6
Tae Suk Oh, Woo Shik Jeong, Taik Jin Chang, Kyung S Koh, Jong-Woo Choi
BACKGROUND: It is difficult to restore original orbital contours because of their complex 3-dimensional structure. Moreover, slight implant malpositioning can result in enophthalmos or other complications. The authors describe our experience of using individualized prebent titanium-Medpor mesh implants and stereolithographic modeling in a series of patients who underwent orbital wall reconstruction. METHODS: A consecutive series of 104 patients with orbital fractures received computer simulation-designed prebent titanium-Medpor mesh implants insertion...
November 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27942886/modified-technique-for-endoscopic-endonasal-reduction-of-medial-orbital-wall-fracture-using-an-absorbable-packing
#7
Pasquale Procacci, L Trevisiol, P F Nocini, V Favero, A D'Agostino
PURPOSE: The purpose of this study was to describe a modified technique using only biological dura substitute (Lyoplant®) associated or not to a sheet of Medpore® (porous polyethylene plate) avoiding the use of Silastic® or Merocel® packing for endoscopic endonasal reduction of medial orbital wall fracture. METHODS: An interventional case report was used involving two patients with medial orbital wall fracture that were treated with the modified technique. Postoperatively, the patients were evaluated for visual acuity, enophthalmos, extraocular motility, and diplopia...
December 10, 2016: Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/27932858/one-stage-bone-strip-reconstruction-technique-with-balloon-sinus-dilatation-surgery-for-chronic-maxillary-atelectasis
#8
Tomoyuki Kashima, Robert A Goldberg, Jocelyne C Kohn, Daniel B Rootman
PURPOSE: Chronic maxillary atelectasis is characterized by unilateral spontaneous enophthalmos and hypoglobus due to increased orbital volume secondary to maxillary sinus inward deformation. Reformation of the sinus architecture and reconstruction of the orbit are key to a successful outcome. Here, we introduce a one-staged surgery that addresses both these goals. PATIENTS AND METHODS: We retrospectively reviewed 11 patients treated with one-stage orbital and sinus surgery...
2016: Clinical Ophthalmology
https://www.readbyqxmd.com/read/27923726/single-stage-soft-tissue-reconstruction-and-orbital-fracture-repair-for-complex-facial-injuries
#9
Peng Sen Wu, Reshvin Matoo, Hong Sun, Li Yuan Song, Don O Kikkawa, Wei Lu
BACKGROUND: Orbital fractures with open periorbital wounds cause significant morbidity. Timing of debridement with fracture repair and soft tissue reconstruction is controversial. This study focuses on the efficacy of early single-stage repair in combined bony and soft tissue injuries. METHODS: Retrospective review. Twenty-three patients with combined open soft tissue wounds and orbital fractures were studied for single-stage orbital reconstruction and periorbital soft tissue repair...
November 11, 2016: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/27913446/use-of-bioresorbable-implants-for-orbital-fracture-reconstruction
#10
Stephanie M Young, Gangadhara Sundar, Thiam-Chye Lim, Stephanie S Lang, George Thomas, Shantha Amrith
PURPOSE: Bioresorbable implants offer several advantages over permanent implants and serve as a useful alternative in the reconstruction of orbital fractures. Our aim of the study was to evaluate the clinical effectiveness and safety of various bioresorbable implants in the repair of orbital fractures. METHODS: A retrospective review of all patients who had undergone orbital fracture repair with bioresorbable implants in a single tertiary trauma centre from January 2005 to December 2014 was performed...
December 2, 2016: British Journal of Ophthalmology
https://www.readbyqxmd.com/read/27905348/the-imploding-antrum-an-unusual-case-of-nontraumatic-painless-enophthalmos
#11
Debraj Sen, Vijinder Arora, Saurabh Adlakha, Harleen Miglani
The imploding antrum or silent sinus syndrome is a rare phenomenon that presents with spontaneous painless enophthalmos and hypoglobus. It occurs due to ipsilateral maxillary antral atelectasis secondary to asymptomatic obstructive chronic sinus mucosal disease. Ophthalmologists, otorhinolaryngologists, and radiologists must be aware of this entity. This article illustrates the typical presentation in a 17-year-old male with unilateral ptosis and a deep superior sulcus, and characteristic imaging findings of ipsilateral increased orbital volume and depression of the orbital floor, maxillary sinus opacification and atelectasis with retraction of the posterolateral and medial walls, lateralization of the uncinate process, and obstruction of the ostiomeatal unit...
October 2016: Indian Journal of Ophthalmology
https://www.readbyqxmd.com/read/27896181/the-correlation-between-the-orbital-volume-ratio-and-enophthalmos-in-unoperated-blowout-fractures
#12
Su Hyun Choi, Dong Hee Kang, Ja Hea Gu
BACKGROUND: Enophthalmos may not appear immediately after trauma due to periorbital swelling in a blowout fracture, and preoperative measurements of enophthalmos cannot be used as a reliable guideline. It is important to predict the eventual final extent of enophthalmos in order to determine whether to perform surgery, and there have been several attempts to predict the degree of late enophthalmos using preoperative orbital volume. The purpose of this study is to investigate the correlation between the orbital volume ratio (OVR) with final enophthalmos and the palpebral fissure, and to find the OVR that induced 2 mm of enophthalmos in unilateral unoperated blowout fractures...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27893559/personalized-reconstruction-of-traumatic-orbital-defects-based-on-precise-three-dimensional-orientation-and-measurements-of-the-globe
#13
Li Huang, Lisong Lin, Zhihong Wang, Bin Shi, Xiaofeng Zhu, Yu Qiu, Yue Huang, Xueyuan Yu, Yunyang Liao
OBJECTIVE: The aim of the study was to precisely assess the severity of traumatic orbital defects and techniques for personalized orbital reconstruction. METHODS: A retrospective study was conducted in 97 patients with traumatic orbital defects who were treated in our hospital between July 2003 and June 2012. Pre- and postoperative spiral computed tomography scans were performed in all patients. A spatial orientation technique was used to measure the three-dimensional position of the globe and calculate the changes in the orbital volume...
November 23, 2016: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/27890546/radiological-evaluation-of-sphenozygomatic-suture-fixation-for-restoration-of-orbital-volume-a-retrospective-study
#14
Rohit Sharma, Chiyyarath Gopalan Muralidharan, Indranil Deb Roy, Narendra Kumar Jain, Seema Patrikar
PURPOSE: Lateral displacement of fracture zygomaticomaxillary complex (ZMC) can cause significant increase in orbital volume leading to enophthalmos. The aim of this study was to radiologically evaluate the efficacy of sphenozygomatic (SZ) suture fixation for restoration of orbital volume after elevation of the temporalis in cases of fracture ZMC where the fixation of zygomatic arch (ZA) was deemed necessary through latero-posterior approach. MATERIALS & METHODS: 43 operated cases of fracture ZMC using 4-point fixation were divided into two groups...
December 2016: Journal of Cranio-maxillo-facial Surgery
https://www.readbyqxmd.com/read/27868452/closed-reduction-of-zygomatic-tripod-fractures-using-a-towel-clip
#15
Anı Cinpolat, Ozlenen Ozkan, Gamze Bektas, Omer Ozkan
BACKGROUND: The zygomatic bone constitutes the prominence of the cheek. Fractures of the zygomatic bone are the second most treatment of zygomatic bone fractures and can be examined under two headings, open and closed reductions. This paper describes a new technique in the closed reduction of tripod fractures using a towel clip. METHODS: Seventeen consecutive patients (three females, 14 males) with a mean age of 35.5 years (range = 18-66 years) with zygomatic tripod fracture were treated using the towel clip technique between December 2011 and February 2014...
November 21, 2016: Journal of Plastic Surgery and Hand Surgery
https://www.readbyqxmd.com/read/27861329/porous-versus-nonporous-orbital-implants-after-enucleation-for-uveal-melanoma-a-randomized-study
#16
Vivian W M Ho, Rumana N Hussain, Gabriela Czanner, Julia Sen, Heinrich Heimann, Bertil E Damato
PURPOSE: To compare hydroxyapatite with acrylic implants after enucleation for uveal melanoma with respect to eyelid position, ocular motility, implant complications, and patient satisfaction. METHODS: Patients undergoing primary enucleation for uveal melanoma between May 2005 and November 2012 at the Liverpool Ocular Oncology Centre, United Kingdom, were randomized between hydroxyapatite and acrylic implants. Questionnaires were sent to patients and ocularists to comment on the main outcomes...
November 17, 2016: Ophthalmic Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/27847307/the-glue-that-holds-the-situation-together
#17
Kyle J Godfrey, Andrew R Harrison, Bobby S Korn, Don O Kikkawa
A 48-year-old man presented with a longstanding left upper eyelid mass that increased in size when bending forward. The mass was associated with enophthalmos and slowly increased in size with Valsalva maneuver. Magnetic resonance imaging and arteriography demonstrated a vascular malformation without an abnormal arterial component. Because of his increasing pain, the vascular malformation was excised in a multidisciplinary approach involving intraoperative fluoroscopic mapping, cyanoacrylate embolization, and surgical excision...
November 12, 2016: Survey of Ophthalmology
https://www.readbyqxmd.com/read/27835055/accessory-extraocular-muscle-as-a-cause-of-restrictive-strabismus
#18
A Molinari, D Plager, P Merino, M M Galan, M Swaminathan, S Ramasuramanian, J T H N de Faber
Restrictive strabismus resulting from the presence of an accessory extraocular muscle has rarely been reported in the literature. Most articles written on this topic are isolated case reports. The purpose of this paper is to describe a series of 7 similar patients presenting with atypical restrictive strabismus associated with enophthalmos in the affected eye, which was found to be caused by an accessory extraocular muscle attached to the posterior globe near the optic nerve. The medical records of 7 patients who shared these clinical characteristics were retrospectively analyzed...
December 2016: Strabismus
https://www.readbyqxmd.com/read/27833708/surgical-treatment-of-orbital-blowout-fractures-complications-and-postoperative-care-patterns
#19
Matthew Shew, Michael P Carlisle, Guanning Nina Lu, Clinton Humphrey, J David Kriet
Orbital fractures are a common result of facial trauma. Sequelae and indications for repair include enophthalmos and/or diplopia from extraocular muscle entrapment. Alloplastic implant placement with careful release of periorbital fat and extraocular muscles can effectively restore extraocular movements, orbital integrity, and anatomic volume. However, rare but devastating complications such as retrobulbar hematoma (RBH) can occur after repair, which pose a risk of permanent vision loss if not addressed emergently...
November 2016: Craniomaxillofacial Trauma & Reconstruction
https://www.readbyqxmd.com/read/27823937/orbital-blowout-fractures-a-novel-ct-measurement-that-can-predict-the-likelihood-of-surgical-management
#20
Tamer N Mansour, Megan Rudolph, Derek Brown, Natalie Mansour, M Reza Taheri
OBJECTIVE: The purpose of this study is to identify an accurate and reliable computed tomographic (CT) measurement that can identify those patients presenting to the emergency department (ED) with orbital floor fracture (BOF) who require surgical repair to prevent ensuing visually debilitating diplopia and/or enophthalmos. METHODS: In this retrospective institutional review board-approved study, we reviewed 99 patients older than 18 years with orbital fractures treated in a level I trauma center from 2011 through 2015...
January 2017: American Journal of Emergency Medicine
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