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Orbital floor fracture

Degala Sai Krishna, Dey Soumadip
PURPOSE: The main aim of our study was to assess and evaluate the efficacy, long standing outcome and infection of porous polyethylene implants in treatment of orbital floor fractures. PATIENT AND METHODS: Twelve patients with fractures of orbital floor were included in the study. The cause of fracture was road traffic accident, self fall and cow hit respectively. They also complained of enophthalmos (n = 9), diplopia (n = 3), restricted eye movement (n = 2), impairment of infraorbital nerve (n = 3) and dystopia (n = 6)...
September 2016: Journal of Maxillofacial and Oral Surgery
Wouter M M T van Hout, Ellen M Van Cann, Ronald Koole, Antoine J W P Rosenberg
: This study investigates treatment outcome in zygomaticomaxillary complex (ZMC) fracture repair. METHODS: The medical records and CT-images of patients that received treatment for a unilateral ZMC fracture in 2005-2011 were studied. ZMC fractures were categorised as incomplete (type A), tetrapod (type B) or comminuted (type C). The incidence of sequelae, wound infection and secondary surgical interventions was analysed per fracture category. RESULTS: A total of 153 patients were treated in the selected period...
September 13, 2016: Journal of Cranio-maxillo-facial Surgery
Heraldo L D da Silveira, Mathias P Fontana, Heloísa E D da Silveira
No abstract text is available yet for this article.
October 12, 2016: Dento Maxillo Facial Radiology
S M Balaji
Ballistic injuries of oral and maxillofacial region are usually fatal due to close propinquity with the vital structures. The severity of injury depends on the caliber of the weapon used and distance from which the patient is shot. The preliminary care of facial ballistic wounds strictly adheres to the basics of trauma resuscitation. Early and appropriate surgical management has proved to be influential on the final outcome and esthetic result. Treatment of facial gunshot wounds should be planned and carried out carefully to avoid esthetic complications...
July 2016: Indian Journal of Dental Research: Official Publication of Indian Society for Dental Research
M-P Vazquez, N Kadlub, V Soupre, E Galliani, C Neiva-Vaz, I Pavlov, A Picard
Facial traumas are common in children but often unconsidered. Facial injury is responsible of impressive bleeding because of the rich vascularization of the face; this bleeding is often underestimated because of the immediate arterial vasoconstriction that is very strong for children. The blood volume is 80ml/kg for a newborn, with a total of 250ml, reaching 70ml/kg at one year of age. The evaluation must be rigorously performed due to the risk of a sudden decompensation. Regarding the wounds, the primary repair must be performed directly neat or optimal in case of damaged tissues...
October 2016: Annales de Chirurgie Plastique et Esthétique
Vikul Kumar, Atul Kumar Singh, Kulwant Singh Bhaikhel
Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from the left eye which suggested tear of dura mater...
April 2016: Journal of Pediatric Neurosciences
Robert D Engle, Mark Chaskes, Edward Wladis, Carlos D Pinheiro-Neto
OBJECTIVE: Fractures of the orbital floor are common yet repaired by various techniques, including open periorbital, transantral endoscopic, and endoscopic endonasal approaches. To date, endoscopic endonasal repair of an orbital floor fracture using an alloplastic implant has not been described. We aim to determine the technique and limitations of completely endoscopic endonasal orbital floor repair using an alloplastic implant. STUDY DESIGN: Cadaveric anatomic study and retrospective case series...
September 7, 2016: Annals of Otology, Rhinology, and Laryngology
Tetsuji Uemura, Takahiro Chuman, Tatsuya Fujii, Aya Morikawa, Mamoru Kikuchi, Hidetaka Watanabe
OBJECTIVE: To ask experts in the field to evaluate a surgeon's experience with a retroseptal transconjunctival approach for the repair of the orbital floor damaged by blowout fracture that the surgeon encountered in 12 East-Asian patients. METHODS: Patients were identified from a database, and a retrospective case note review was conducted. A total of 12 conjunctival procedures were conducted for the repair of blowout fracture with no other complicating fractures...
May 2016: Plastic and Reconstructive Surgery. Global Open
Erica Kristen Ludi, Saurabh Rohatgi, Matthew E Zygmont, Faisal Khosa, Tarek N Hanna
OBJECTIVE: The objective of the present study is to examine the concordance of facial fracture classifications in patients with trauma who underwent surgery and to assess the epidemiologic findings associated with facial trauma. MATERIALS AND METHODS: Patients with trauma who underwent facial CT examination and inpatient operative intervention during a 1-year period were retrospectively analyzed. Patient demographic characteristics, the mechanism of injury, the radiology report, the surgical diagnosis, and clinical indications were reviewed...
August 24, 2016: AJR. American Journal of Roentgenology
Yuichiro Ishida, Yasuhiro Takahashi, Yoshiyuki Kitaguchi, Hirohiko Kakizaki
Orbital floor fractures commonly occur just medial to the junction of the infraorbital nerve and the inferior orbital fissure because the bone is thinner posteromedial to the infraorbital nerve than that lateral to the nerve. The authors previously reported 2 pediatric patients with an isolated orbital floor fracture lateral to the infraorbital nerve. The authors showed that, on the unaffected side of these patients, the lateral portion of the orbital floor was thinner than the medial portion. In the present study of 5 adult patients with an isolated orbital floor fracture lateral to the infraorbital nerve, the authors compared the thickness of the medial and lateral portions of the orbital floor with that of the infraorbital nerve on the unaffected side...
October 2016: Journal of Craniofacial Surgery
Ho Kwon, Ho Jun Kim, Bommie F Seo, Yeon Jin Jeong, Sung-No Jung, Hyung-Sup Shim
It is essential to reduce and reconstruct bony defects adequately in large orbital floor fracture and defect. Among many reconstructive methods, alloplastic materials have attracted attention because of their safety and ease of use. We have used resorbable plates combined with artificial bone substitutes in large orbital floor defect reconstructions and have evaluated their long-term reliability compared with porous polyethylene plate. A total of 147 patients with traumatic orbital floor fracture were included in the study...
2016: BioMed Research International
Sarah Willcox DeParis, F Lawson Grumbine, M Reza Vagefi, Robert C Kersten
Here we present two cases of marked postoperative upgaze restriction after successful repair of orbital floor fracture and release of inferior rectus entrapment. In both cases, follow-up imaging showed enlargement of the inferior rectus, and gradual resolution of gaze limitation was observed over several months of conservative management. Thus, in patients with postoperative findings suggestive of residual inferior rectus entrapment, follow-up imaging is indicated prior to returning to the operating room. With a markedly swollen inferior rectus muscle but no radiographic evidence of residual muscle entrapment in the fracture, a trial of conservative management may be warranted...
September 2016: Craniomaxillofacial Trauma & Reconstruction
Yasuhiro Takahashi, Takashi Nakano, Hidetaka Miyazaki, Hirohiko Kakizaki
PURPOSE: To examine the anatomy of the orbital floor in relation to the infraorbital groove. METHODS: Twenty-two Japanese cadavers aged 86.9 ± 6.0 years at death were used. We examined whether the bony overhang on the infraorbital nerve extending laterally was connected to the segment medial to the infraorbital groove. The bone thicknesses at 1, 2, and 3 mm anterior to the junction between the infraorbital groove and the inferior orbital fissure were measured along the groove...
October 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Anson Nguyen, Trung Ho, Marcin Czerwinski
Orbital fractures are common, accounting for nearly 40% of all facial fractures. Open repair is required to restore preinjury orbital volume and relieve any extra-ocular muscle entrapment. Monitoring for postoperative intraorbital hemorrhage, and its consequent potential for visual impairment, has triggered most surgeons to observe their patients in the hospital overnight postoperatively. The real risk of postoperative hemorrhage in this patient group, however, is uncertain and the need to contain healthcare costs clear...
October 2016: Journal of Craniofacial Surgery
Eleonora Segna, Giada Anna Beltramini, Alessandro Baj, Aldo Bruno Giannì, Francesco Concetto Laganà
The best treatment of pediatric orbital fractures is debated and different strategies are proposed in the literature. Resorbable materials, due to their features and the specific requirements of the pediatric population, seem a very suitable choice. The authors present their experience by describing 3 cases and explaining their mesh modeling technique. Two fractures were caused by accidental falls, whereas the other resulted from aggression. Clinical and radiological evaluation (computed tomography scanning) was performed before surgery...
October 2016: Journal of Craniofacial Surgery
Alisa Timashpolsky, Alexander B Dagum, Syed M Sayeed, Jamie L Romeiser, Elisheva A Rosenfeld, Nicole Conkling
BACKGROUND: There are >150,000 patient visits per year to emergency rooms for facial trauma. The reliability of a computed tomography (CT) scan has made it the primary modality for diagnosing facial skeletal injury, with the physical examination playing more a cursory role. Knowing the predictive value of physical findings in facial skeletal injuries may enable more appropriate use of imaging and health care resources. OBJECTIVE: A blinded prospective study was undertaken to assess the predictive value of physical examination findings in detecting maxillofacial fracture in trauma patients, and in determining whether a patient will require surgical intervention...
2016: Plastic Surgery
Achille Tarsitano, Giovanni Badiali, Angelo Pizzigallo, Claudio Marchetti
OBJECTIVE: Enophthalmos is a severe complication of primary reconstruction of orbital floor fractures. The goal of secondary reconstruction procedures is to restore symmetrical globe positions to recover function and aesthetics. The authors propose a new method of orbital floor reconstruction using a mirroring technique and a customized titanium mesh, printed using a direct metal laser-sintering method. METHODS: This reconstructive protocol involves 4 steps: mirroring of the healthy orbit at the affected site, virtual design of a patient-specific orbital floor mesh, CAM procedures for direct laser-sintering of the customized titanium mesh, and surgical insertion of the device...
October 2016: Journal of Craniofacial Surgery
Guilherme Dos Santos Trento, Lucas Borin Moura, Luis Fernando de Oliveira Gorla, Valfrido Antônio Pereira Filho
Midface fractures usually affect the orbital cavity. This trauma may result in severe and rare consequences such as retrobulbar hemorrhage. This condition requires immediate diagnosis and early intervention to avoid blindness. The treatment usually requires evaluation of an oral and maxillofacial surgeon. This patient report aims to describe a facial trauma resulting in blindness after 4 days. An 83-year-old woman fell and hit her face on the floor. The initial evaluation only found a contusion on her left orbit, and an ophthalmologic examination was not made...
September 2016: Journal of Craniofacial Surgery
Joseph M Baylan, Daniel Jupiter, Wendy L Parker, Marcin Czerwinski
INTRODUCTION: Repair of zygomatic fractures can be classified into the early closed reduction or the more recent open reduction and rigid internal fixation (ORIF) methods. Surgical training and literature advocate ORIF, but the actual frequency of the different techniques in clinical practice is unknown. The purpose of this study was to determine the current trends in the management of zygomatic fractures among US surgeons and elucidate their influences. METHODS: A 10-question survey was developed and distributed to over 16,000 practicing US facial trauma surgeons, including plastic surgeons (PS), oral and maxillofacial surgeons (OMFS), and otorhinolaryngologists (ENT)...
September 2016: Journal of Craniofacial Surgery
Saurabh Kumar, S Shubhalaksmi
BACKGROUND: The increasing emphasis on the open reduction and internal fixation of orbito-zygomatico-maxillary complex fractures has led to a more critical appraisal of the various surgical approaches to the orbital and zygomatic skeleton. Transconjunctival approach popularized by Tessier although credited to Bourquet in 1924 offer excellent exposure of the orbito-zygomatico-maxillary complex fracture especially the infra-orbital rim, frontozygomatic suture and the orbital floor. The argument against a transconjunctival access focuses primarily on concern about limited exposure that apparently makes accurate reduction and osteosynthesis of displaced fracture fragments difficult or impossible...
April 2016: Contemporary Clinical Dentistry
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