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Orbital floor fracture

Agata Joanna Ordon, Marcin Kozakiewicz, Michal Wilczynski, Piotr Loba
INTRODUCTION: Up to 35% of orbital floor fractures extend to the medial wall. This results in restriction of both abduction and adduction, leading to horizontal diplopia. The greater the defect, the more pronounced the enophthalmos. AIM OF THE STUDY: The aim of the study was to determine the influence of concomitant medial wall defects on enophthalmos and diplopia, and the influence of intraoperative revision on the results of surgical reconstruction in patients with orbital floor fracture...
February 3, 2018: Journal of Cranio-maxillo-facial Surgery
Marina Alexandra Gavin Clavero, María Victoria Simón Sanz, Andrea Mur Til, Úrsula María Jariod Ferrer
PURPOSE: We conducted a review of orbital fractures treated in our hospital over a period of 4 years. We reviewed several complications of such fractures, especially the relationship of postsurgical diplopia with different presurgical variables: age, gender, type of fracture, fracture area, coronal and sagittal diameter of fracture, fractured floor area, time to surgery, presence of muscle herniation, and presence of muscle entrapment. PATIENTS AND METHODS: Fractures involving the orbital floor remain a controversial issue in terms of surgical treatment and the time from trauma to surgery...
February 19, 2018: Journal of Oral and Maxillofacial Surgery
Omri Emodi, Saleh Nseir, Dekel Shilo, Hanna Srouji, Adi Rachmiel
Isolated orbital wall fractures account for 4% to 16% of all facial fractures. Even a modest change in the position of the bony walls can have a significant impact on orbital volume and globe position. Alloplastic materials or autogenous bone grafts such as the antral maxillary wall can be used to reconstruct small- to medium-size orbital fractures. The main advantage of an antral wall graft is the intraoral approach with minimal morbidity. Nine patients underwent repair of orbital floor fractures using the extraoral and the intraoral antral wall approach...
March 8, 2018: Journal of Craniofacial Surgery
Ulrik Nikolaj Ascanius Felding
Isolated fractures of the orbital floor or medial wall are often referred to as blowout fractures (BOFs). Debilitating double vision and aesthetic deformity may affect the patients' quality of life and daily living skills, for instance, working or driving a car. The management of blowout fractures is, however, challenging, since not all fractures demand surgery. Some patients may have symptoms which subside, or may never develop symptoms. Due to a lack of evidence, there are still considerable differences in opinion on the criteria for surgery...
March 2018: Danish Medical Journal
Angelica W DesPain, Jennifer Chapman, Haroon Shaukat
We describe the case of a 6-year-old boy who presented to a tertiary care emergency department after a motor vehicle accident with facial trauma and bradycardia. The patient was found to have an orbital floor fracture and inferior rectus muscle entrapment with resulting bradycardia secondary to the oculocardiac reflex. The oculocardiac reflex is an uncommon cause of bradycardia in the setting of trauma but should be considered because it can necessitate surgical intervention.
February 28, 2018: Pediatric Emergency Care
Dan Zhao, Shanwei Tao, Dewei Zhang, Mengyang Qin, Yijun Bao, Anhua Wu
PURPOSE: Traumatic meningoencephalocele primarily occurs as a rare but complex complication of cranial base and orbital roof fractures. Traumatic intraorbital meningoencephalocele, which is rare and easily overlooked, can be life-threatening since cephalomeningitis occurs due to cerebrospinal fluid (CSF) leakage. It is obscure for the operative indications or standard surgical methods of traumatic meningoencephaloceles since the combined intricate craniofacial and basal fractures, brain injury, and CSF leak may exist...
February 27, 2018: Brain Injury: [BI]
Todd E Thurston, Anee S Jackson, Naiman Nazir, Brian T Andrews, Danielle Crowe
INTRODUCTION: Ideally, all patients with isolated orbit fracture would undergo ophthalmologic evaluation before surgical intervention to rule out concomitant globe injury and possible vision loss. Unfortunately, not all institutions are capable of providing the evaluation before surgery. The authors hypothesize that the anatomic location of a single-wall orbit isolated orbit fracture can help predict the likelihood of ocular injury and thus identify high-risk patients who mandate ophthalmologic evaluation before surgical repair...
February 23, 2018: Journal of Craniofacial Surgery
Sophia Seen, Stephanie Ming Young, Shao Jin Teo, Stephanie S Lang, Shantha Amrith, Thiam-Chye Lim, Gangadhara Sundar
PURPOSE: To compare the outcomes of bioresorbable and permanent implants in the reconstruction of isolated orbital floor blowout fractures. METHODS: Retrospective series of all patients who had orbital floor fracture repair in a single tertiary trauma center from January 2005 to December 2014. The authors reviewed the case notes and CT scans of patients with orbital floor fracture repair with either bioresorbable or permanent implants. Main outcome measures were enophthalmos, diplopia, and ocular motility restriction 1...
February 6, 2018: Ophthalmic Plastic and Reconstructive Surgery
Salem Barcic, Michael Blumer, Harald Essig, Paul Schumann, Daniel B Wiedemeier, Martin Rücker, Thomas Gander
Transconjunctival approach has become a standard procedure to access fractures of orbit and the infraorbital rim. The transconjunctival incision can be performed pre- or retroseptally. Both approaches have been described combined with modifications such as transcaruncular or detachment of the lateral canthus for wider exposure of the orbital walls and rim. Particularly concerning aesthetics, the transconjunctival approach shows advantages compared to the transcutaneous incisions, such as the transciliary and infraorbital access...
December 24, 2017: Journal of Cranio-maxillo-facial Surgery
Panxi Yu, Zhen Zhai, Xiaolei Jin, Xiaonan Yang, Zuoliang Qi
BACKGROUND: Platelet-rich fibrin (PRF) has been applied in the clinical field for more than a decade, but largely in oral surgery and implant dentistry. Its utilization in plastic and reconstructive surgery is limited and lacking a comprehensive review. Hence, this article focuses on the various clinical applications of PRF pertaining to the plastic and reconstructive field through a systematic review. METHODS: In this review, articles describing the clinical application of PRF in plastic and reconstructive surgery were screened using predetermined inclusion and exclusion criteria...
February 2, 2018: Aesthetic Plastic Surgery
Stephanie M Young, Yan Tong Koh, Errol W Chan, Shantha Amrith
The aim of this study was to evaluate the incidence, clinical features, and risk factors of sustaining inferior rectus (IR) palsy in a group of pediatric patients with orbital floor blowout fractures. We performed a retrospective case review of sequential cases of pediatric orbital floor blowout fractures (<18 years old) from 2000 to 2013 in a tertiary ophthalmic center in Singapore. A total of 48 patients were included in our study, of whom 5 had IR palsy (10.4%). Patients with IR palsy had a higher mean age (16...
March 2018: Craniomaxillofacial Trauma & Reconstruction
Siwei Zhou, Katherine Duncan, S Tonya Stefko
Silent sinus syndrome was first described as spontaneous enophthalmos and hypoglobus associated with subclinical maxillary sinusitis without prior trauma or surgery. This clinical entity has later been described after trauma in which damage to the ostiomeatal complex leads to atelectasis of the maxillary sinus. We report a case of a 14-year-old boy who presented 4 years after sustaining a non-operative orbital floor fracture with enophthalmos and transient diplopia. Computed tomography (CT) demonstrated enlargement in size of the original orbital floor fracture and bilateral maxillary sinus disease...
January 10, 2018: Orbit
Jonathan M Carrere, Kyle T Lewis
Complete extraocular muscle transection is uncommon in the setting of blunt trauma. We report a case of a 53-year-old male that developed diplopia after hitting his face directly on a concrete slab after a fall. On examination, he had a right hypertropia with a complete infraduction deficit. A CT scan of the face showed an orbital floor blowout fracture with complete inferior rectus transection. On surgical exploration, the distal and proximal ends of the muscle were identified and sutured together, and the floor fracture was repaired...
January 5, 2018: Orbit
Shao-Rui Liu, Mao Li, Fang-Lin He, Zheng-Kang Li, Xian-Qun Fan
OBJECTIVE: At present, the effect of the visual electrophysiology and vision field examination in patients with orbital blowout fracture is rarely studied. So, the authors investigate the value of visual electrophysiology and vision field examination in the diagnosis of ocular contusion. METHODS: The position and range of fracture of 81 patients were determined by computed tomography (CT) scanning. Visual evoked potential (VEP), electroretinogram (ERG), and mfERG were vision field examination detected in 81 patients and the results were compared with those of contralateral healthy eyes...
January 2018: Journal of Craniofacial Surgery
Chau M Pham, Steven M Couch
Purpose: To review the physiology, presentation and management of the oculocardiac reflex (OCR) by describing a case of the OCR associated with an orbital foreign body and complete ocular prolapse through a large orbital floor fracture in a 40-year-old male following a motor vehicle accident. Observations: The patient demonstrated marked bradycardia and hypotension necessitating intubation and medical therapy for autonomic shock. A computed tomography (CT) showed a total blow out floor fracture and complete dislocation of a radiographically intact globe with uninterrupted rectus muscle attachments into the left maxillary sinus...
June 2017: American Journal of Ophthalmology Case Reports
Michele Runci, Francesco Saverio De Ponte, Roberto Falzea, Ennio Bramanti, Floriana Lauritano, Gabriele Cervino, Fausto Famà, Alessandro Calvo, Salvatore Crimi, Silvia Rapisarda, Marco Cicciù
Background: Orbital fractures are classified as diseases usually related to common midface trauma. It represents the most challenging treatment due to the complex anatomy, physiology, and aesthetic role. A midface trauma involves also the zygomatic complex and the nose, however the orbit fracture seems to be a more frequent disease due to its anatomical features. Objective: The purpose of this work is to retrospectively evaluate and record the frequency of the midfacial traumas and orbital fractures observed in the North Eastern Sicily...
2017: Open Dentistry Journal
Young Chul Kim, Kyung Hyun Min, Jong Woo Choi, Kyung S Koh, Tae Suk Oh, Woo Shik Jeong
BACKGROUND: The management of combined orbital floor and medial wall fractures involving the inferomedial strut is challenging due to absence of stable cornerstone. In this article, we proposed surgical strategies using customized 3D puzzle implant preformed with Rapid Prototype (RP) skull model. METHODS: Retrospective review was done in 28 patients diagnosed with combined orbital floor and medial wall fracture. Using preoperative CT scans, original and mirror-imaged RP skull models for each patient were prepared and sterilized...
November 29, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
Joy Mh Wang, Fabian N Fries, Philipp Hendrix, Titus Brinker, Marios Loukas, R Shane Tubbs
This rare case report describes the diagnosis and treatment of an isolated left-sided orbital floor fracture with a complete dislocation of the globe into the maxillary sinus and briefly discusses the indications of surgery and recovery for orbital floor fractures in general. Complete herniation of the globe through an orbital blow-out fracture is uncommon. However, the current case illustrates that such an occurrence should be in the differential diagnosis and should be considered, especially following high speed/impact injuries involving a foreign object...
September 29, 2017: Curēus
Li Xiaoyu, Wu Jing, Du Xinya, Huang Jian, Wu Bin, Xie Chun
OBJECTIVE: To evaluate the clinical effects of bone graft from the mandible in repairing orbital floor defects. METHODS: Bone grafts from the mandible were used to treat 11 cases of orbital floor defects and followed up for 6-12 months. RESULTS: The surgical incisions healed primarily in all 11 patients. The orbital floor structure was restored. No vision loss, limited eye movement, implant infection, or resorption were observed postoperatively, and no complications occurred in the supply area...
October 1, 2017: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
Junhyung Kim, Sang Woo Park, Jaehoon Choi, Woonhyeok Jeong, Ryeolwoo Kim
In this study, details of the infraorbital nerve's (ION's) anatomical course variants were compared using computed tomography (CT), and relationships between the variants and fracture patterns in the orbital floor were investigated. Fifty-two normal individuals and 50 patients with unilateral isolated orbital floor fractures were enrolled in this study. Four measurements in normal individuals and five measurements in fracture patients were obtained in parasagittal sections. The anatomical variations of the ION were categorized into three types according to the classification by Ferences et al...
October 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
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