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Orbital anatomy and trauma

Obaid Chaudhry, Matthew Isakson, Adam Franklin, Suhair Maqusi, Christian El Amm
LEARNING OBJECTIVES: After studying this article, the participant should be able to: 1. Describe the A-frame configuration of anterior facial buttresses, recognize the importance of restoring anterior projection in frontal sinus fractures, and describe an alternative design and donor site of pericranial flaps in frontal sinus fractures. 2. Describe the symptoms and cause of pseudo-Brown syndrome, describe the anatomy and placement of a buttress-spanning plate in nasoorbitoethmoid fractures, and identify appropriate nasal support alternatives for nasoorbitoethmoid fractures...
May 2018: Plastic and Reconstructive 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
Pradeep Goyal, Steven Lee, Nishant Gupta, Yogesh Kumar, Manisha Mangla, Kusum Hooda, Shuo Li, Rajiv Mangla
Orbital apex disorders include orbital apex syndrome, superior orbital fissure syndrome and cavernous sinus syndrome. These disorders result from various etiologies, including trauma, neoplastic, developmental, infectious, inflammatory as well as vascular causes. In the past, these have been described separately based on anatomical locations of disease process; however, these three disorders share similar causes, diagnostic evaluation and management strategies. The etiology is diverse and management is directed to the causative process...
April 2018: Neuroradiology Journal
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
Mei Chen Liu, Xiao Rui Yin, Yi Shui Zhang, Wen Yang, Han Wen Zhang, Hao Bo Duan, Jian Ming Liu, Kai Liang Cheng, You Qiong Li
With the development of endoscopic technique, Caldwell-Luc approach has more wide applications and becomes a common method of pterygopalatine fossa (PPF) surgery. Few data can be used in this approach to avoid injuring the vessels and nerves within this area. In this study, the authors used computed tomography to get the coordinates of inferior orbital fissure, foramen rotundum, sphenopalatine foramen, internal opening of pterygoid canal, the strangulation of PPF, and the greater palatine foramen with canine fossa as the origin...
September 2017: Journal of Craniofacial Surgery
Ian C Hoppe, Jordan N Halsey, Frank S Ciminello, Edward S Lee, Mark S Granick
Introduction: Palatal fractures are frequently associated with facial trauma and Le Fort fractures. The complex anatomy of the midfacial skeleton makes diagnosing and treating these injuries a challenge. The goal of this study was to report our experience with the presentation, concomitant injuries, and management of palatal fractures at a level I trauma center in an urban environment. Methods: Data were collected for all palatal fractures diagnosed between January 2000 and December 2012 at the University Hospital in Newark, NJ...
2017: Eplasty
Jarett Thelen, Asha A Bhatt, Alok A Bhatt
Acute ocular trauma accounts for a substantial number of emergency department visits in the USA, and represents a significant source of disability to patients; however, the orbits remain a potential blind spot for radiologists. The goal of this article is to review the relevant anatomy of the orbit and imaging findings associated with commonly encountered acute ocular traumatic pathology, while highlighting the salient information which should be reported to the ordering clinician. Topics discussed include trauma to the anterior and posterior chamber, lens dislocations, intraocular foreign bodies, and open and contained globe injuries...
October 2017: Emergency Radiology
Pedro Henrique da Hora Sales, Suellen Sombra da Rocha, Paulo Henrique Carvalho Rodrigues, Edson Luiz Cetira Filho, Leonardo de Freitas Silva, Manoel de Jesus Rodrigues Mello
Orbital fractures are injuries frequently related to traumas of the midface. These fractures can be associated with ocular lesions, ranging from small abrasions on the cornea to serious complications such as hyphema and ocular globe rupture. Diplopia and ophthalmoplegia are common findings in orbital fractures. They can be caused by mechanical factors as bone fragments or muscle imprisonment. The aim of this study was to report a case of a 40-year patient, male showing diplopia and ophthalmoplegia due to the orbital fracture...
July 2017: Journal of Craniofacial Surgery
Viet D Nguyen, Achint K Singh, Wilson B Altmeyer, Bundhit Tantiwongkosi
Imaging of the orbit plays an important role in the workup of orbital emergencies. Orbital imaging is particularly useful in the emergency department, where clinical history and physical examination may be limited or delayed until the exclusion or treatment of more life-threatening conditions. Cross-sectional orbital imaging with multidetector computed tomography (CT) and magnetic resonance (MR) imaging is commonly performed in addition to ultrasonography. In an emergent setting, CT is the preferred modality when evaluating for intraorbital foreign bodies, fractures, or calcifications within a mass lesion...
May 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Alan Scott Herford, Meagan Miller, Floriana Lauritano, Gabriele Cervino, Fabrizio Signorino, Carlo Maiorana
Virtual surgical planning (VSP) has recently been introduced in craniomaxillofacial surgery with the goal of improving efficiency and precision for complex surgical operations. Among many indications, VSP can also be applied for the treatment of congenital and acquired craniofacial defects, including orbital fractures. VSP permits the surgeon to visualize the complex anatomy of craniofacial region, showing the relationship between bone and neurovascular structures. It can be used to design and print using three-dimensional (3D) printing technology and customized surgical models...
February 2017: Chinese Journal of Traumatology, Zhonghua Chuang Shang za Zhi
YongSeok Nam, Sujin Bahk, SuRak Eo
The infraorbital nerve (ION) can easily be damaged by orbital trauma and periorbital surgical manipulations, due to its abutment to the orbital floor. Anatomic variability of the ION and surrounding structures has infrequently been documented. The aim of this study is to give precise anatomical knowledge about the ION with surrounding structures, to avoid iatrogenic injury of the ION during periorbital procedures.Forty orbits of 40 skull subjects (20 males and 20 females) were studied to analyze structures around the ION...
June 2017: Journal of Craniofacial Surgery
Bijan Beigi, Deepak Vayalambrone, Mohsen Bahmani Kashkouli, Peter Prinsley, Jan Saada
PURPOSE: To present a technique to improve the surgical treatment of frontal sinus mucocele and its recurrence. METHODS: Nine procedures performed on eight patients by a team of ENT and Ophthalmic orbital surgeons. Data collected included patient demographics, surgical details, pathological findings and complications. The surgical technique involved an external approach via the upper eyelid skin crease combined with an internal approach with a rigid 4 mm endoscope described below...
March 2016: Journal of Current Ophthalmology
Michael J Reiter, Ryan B Schwope, Jared M Theler
OBJECTIVE: The purpose of this article is to describe both the expected and unexpected imaging features of posttraumatic defects of the orbital skeleton after surgical repair. CONCLUSION: The goal of surgery is to restore the preinjury orbital anatomy to improve function and prevent enophthalmos. Radiologists need to be cognizant of the more frequently encountered operative procedures used for orbital fracture repair, the desired goals of treatment, and common complications...
June 2016: AJR. American Journal of Roentgenology
Susmitha Rajmohan, David Tauro, Bhupesh Bagulkar, Anuj Vyas
AIMS: The coronal incision with its various modifications provides the most versatile approach to various areas in the craniomaxillofacial region coupled with excellent exposure. The aesthetic advantage of a hidden scar in the hairline, accounts for its continued popularity. The aim of this study was to review the surgical anatomy, technique and problems of post-operative morbidity pertinent to coronal approach in various clinical situations such as craniofacial trauma, tumour resections and reconstructive craniofacial procedures...
August 2015: Journal of Clinical and Diagnostic Research: JCDR
Gerson Mast, Michael Ehrenfeld, Carl-Peter Cornelius, Ralph Litschel, Abel-Jan Tasman
Fractures of the midface and internal orbit occur isolated or in combination with other injuries. Frequently, the patients are first seen in emergency rooms responsible for the coordination of initial diagnostic procedures, followed by the transfer to specialties for further treatment. It is, therefore, important for all physicians treating facial trauma patients to understand the basic principles of injuries to the midface. Thus, this article aims to describe the anatomy and the current classification systems in use, the related clinical symptoms, and the essential diagnostic measures to obtain precise information about the injury pattern...
August 2015: Facial Plastic Surgery: FPS
W Reith, U Yilmaz
The aim of this 2-part review article on diseases of the orbit is to give the reader an insight into the anatomical structure and an overview of the most important diseases in the area of the eye socket. The main focus is on a description of the imaging procedures and their individual advantages and disadvantages. The most important tumors, trauma and degenerative alterations of the orbit are also described.
August 2015: Der Radiologe
Felicity Victoria Connon, S J B Austin, A L Nastri
Orbital roof fractures are relatively uncommon in craniofacial surgery but present a management challenge due to their anatomy and potential associated injuries. Currently, neither a classification system nor treatment algorithm exists for orbital roof fractures, which this article aims to provide. This article provides a literature review and clinical experience of a tertiary trauma center in Australia. All cases admitted to the Royal Melbourne Hospital with orbital roof fractures between January 2011 and July 2013 were reviewed regarding patient characteristics, mechanism, imaging (computed tomography), and management...
September 2015: Craniomaxillofacial Trauma & Reconstruction
Robert A Clark
The rectus extraocular muscles (EOMs) and inferior oblique muscle have paths through the orbit constrained by connective tissue pulleys. These pulleys shift position during contraction and relaxation of the EOMs, dynamically changing the biomechanics of force transfer from the tendon onto the globe. The paths of the EOMs are tightly conserved in normal patients and disorders in the location and/or stability of the pulleys can create patterns of incomitant strabismus that may mimic oblique muscle dysfunction and cranial nerve paresis...
July 2015: Middle East African Journal of Ophthalmology
Christopher G T Lim, Duncan I Campbell, Nicholas Cook, Jason Erasmus
In Christchurch Hospital, rapid prototyping (RP) and intraoperative imaging are the standard of care in orbital trauma and has been used since February 2013. RP allows the fabrication of an anatomical model to visualize complex anatomical structures which is dimensionally accurate and cost effective. This assists diagnosis, planning, and preoperative implant adaptation for orbital reconstruction. Intraoperative imaging involves a computed tomography scan during surgery to evaluate surgical implants and restored anatomy and allows the clinician to correct errors in implant positioning that may occur during the same procedure...
June 2015: Craniomaxillofacial Trauma & Reconstruction
Michal Kyllar, Jan Štembírek, Zdenek Danek, Radek Hodan, Jiří Stránský, Vladimír Machoň, René Foltán
Due to its similarity to humans, the pig has proven to be a suitable biomodel for both research purposes and for training medical professionals, particularly in surgical specializations. For example, new implant materials have been tested on pig jaws and pigs have also been used in the development of new surgical techniques. For optimizing the effectiveness of such research or training, detailed data on the anatomy of their particular features are needed. At present, however, only limited information related to surgical and imaging anatomy of the facial and orbital areas of the pig and its comparison to human structures from the experimental surgery point of view is available in the literature...
April 2016: Laboratory Animals
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