Case series of 132 patients with orbital floor fractures via a “sutureless” transconjunctival approach

2017 ◽  
Vol 55 (10) ◽  
pp. e135
Author(s):  
Alexandra Green ◽  
Michael Perry
Keyword(s):  
Case Series ◽  
Orbital Floor ◽  
Transconjunctival Approach ◽  
Orbital Floor Fractures

scholarly journals Blowout Fracture in a 3-Year-Old

2013 ◽  
Vol 6 (2) ◽  
pp. 133-136 ◽  
Author(s):  
Britt I. Pluijmers ◽  
Maarten J. Koudstaal ◽  
Dion Paridaens ◽  
Karel G.H. van der Wal
Keyword(s):  
Young Children ◽  
Surgical Planning ◽  
Clinical Symptoms ◽  
Orbital Floor ◽  
Conservative Approach ◽  
Transconjunctival Approach ◽  
Blowout Fracture ◽  
Fractures In Children ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction

A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed.

Transconjunctival Approach Using Lateral Skin Extension for Reconstruction of Orbit Zygomatic Complex Fractures: Technique Description and a Case Series Analysis

2020 ◽  
pp. 194338752097008
Author(s):  
Salvador Valladares Pérez ◽  
Diego Bustamante Correa ◽  
Carlos Cortez Fuentes ◽  
Felipe Astorga Mori ◽  
Gerson Sepúlveda Troncoso ◽  
...  
Keyword(s):  
Maxillofacial Surgery ◽  
Case Series ◽  
Lateral Wall ◽  
Orbital Floor ◽  
Oral And Maxillofacial Surgery ◽  
Transconjunctival Approach ◽  
Unique Approach ◽  
Orbital Rim ◽  
Infraorbital Rim

Study Design: A descriptive-observational study of a series case report of patients diagnosed with orbito-zygomatic complex (OZMC) fracture with lateral wall involvement, was conducted. All patients were assessed in the Oral and Maxillofacial Surgery Service at Hospital El Carmen, Maipu, Santiago, Chile. Objective: The purpose of this study was to evaluate a single-institution experience with the transconjunctival approach to the orbit, utilizing a lateral skin extension as unique approach to access to fronto-zygomatic suture, infraorbital rim and/or orbital floor. Method: The authors identified 41 patients with OZMC fractures who underwent to surgical treatment over a 45 months period. Among this group, 21 patients needed fixation with osteosynthesis of the frontozygomatic suture, and 16 of whom were treated with the approach being studied. The authors assessed scleral exposure, eyelid position changes, ectropion, and entropion as outcome measures, and reported satisfactory outcomes at a minimum of 9 months follow-up. Conclusions: This study concludes that in our experience, the transconjunctival approach utilizing a lateral skin extension allows a direct, easy, and quick access to the entire infra orbital rim, orbital floor, fronto-zygomatic suture and lateral wall of the orbit, up to spheno-zygomatic suture, with low associated morbidity and complications.

scholarly journals Survey of Common Practices among Oculofacial Surgeons in the Asia-Pacific Region: Management of Orbital Floor Blowout Fractures

2014 ◽  
Vol 7 (3) ◽  
pp. 197-202 ◽  
Author(s):  
Victor Koh ◽  
Nathalie Chiam ◽  
Gangadhara Sundar
Keyword(s):  
Surgical Intervention ◽  
Asia Pacific ◽  
Orbital Floor ◽  
Pacific Region ◽  
Asia Pacific Region ◽  
Transconjunctival Approach ◽  
Total Response Rate ◽  
Orbital Floor Fractures ◽  
Common Practices ◽  
Year 2000

A web-based anonymous survey was performed to assess common practices of oculofacial surgeons in the management of traumatic orbital floor blowout fractures. A questionnaire which contained questions on several controversial topics in the management of orbital floor fractures was sent out via e-mail to 131 oculofacial surgeons in 14 countries in the Asia-Pacific region. A total response rate of 58.3% was achieved from May to December 2012. The preferred time for surgical intervention was within 2 weeks for adult patients, porous polyethylene implant was the most popular choice, and most surgeons preferred the transconjunctival approach. Postoperatively, diplopia was the most commonly encountered complication and most oculofacial surgeons reviewed their patients regularly for up to 12 months. We report the results of the first survey of oculofacial surgeons within the Asia-Pacific region on the management of orbital floor blowout fractures. Compared with previous surveys (from year 2000 to 2004), the duration to surgical intervention was comparable but there was a contrasting change in preferred surgical approach and choice of orbital implant.

Lower eyelid suspension after transconjunctival approach to orbital floor fractures

2009 ◽  
Vol 47 (7) ◽  
pp. e34
Author(s):  
Bagrat Lalabekyan ◽  
Bagrat Lalabekyan ◽  
Colin Hopper ◽  
Naresh Joshi ◽  
Niall Kirckpatrick
Keyword(s):  
Lower Eyelid ◽  
Orbital Floor ◽  
Transconjunctival Approach ◽  
Orbital Floor Fractures

scholarly journals Management of orbital floor fractures-A case series

2021 ◽  
Vol 12 (5) ◽  
pp. 135-139
Author(s):  
Devakumari Shanmugam ◽  
Vijhayapriya Thanasekar
Keyword(s):  
Clinical Examination ◽  
Surgical Approach ◽  
Case Series ◽  
Orbital Floor ◽  
Radiographic Assessment ◽  
Maxillofacial Region ◽  
Implant Placement ◽  
Orbital Floor Fractures ◽  
Zygomatic Fractures ◽  
Case Basis

Orbital floor fractures are the most challenging fractures to be managed in maxillofacial region. They are diagnosed in isolation or in combination with mid face fractures, Lefort fractures and zygomatic fractures. The treatment depends on the displacement of the fractured bones and the manifestations of muscle entrapment elicited by clinical examination and radiographic assessment. The timing of repair is of paramount importance and decided on the case to case basis. Proper surgical approach along with appropriate implant placement is the key to success. This paper describes a series of 11 patients operated in IGMC&RI, Puducherry for orbital floor fractures from 2010 to 2019.

scholarly journals Transcaruncular Approach for Treatment of Medial Wall and Large Orbital Blowout Fractures

2016 ◽  
Vol 9 (1) ◽  
pp. 046-054 ◽  
Author(s):  
Dennis C. Nguyen ◽  
Farooq Shahzad ◽  
Alison Snyder-Warwick ◽  
Kamlesh B. Patel ◽  
Albert S. Woo
Keyword(s):  
Case Series ◽  
Medial Wall ◽  
Level Of Evidence ◽  
Transconjunctival Approach ◽  
Retrobulbar Hematoma ◽  
Orbital Floor Fractures ◽  
Orbital Wall ◽  
Orbital Blowout Fractures ◽  
Medial Orbital Wall ◽  
Lateral Canthotomy

We evaluate the safety and efficacy of the transcaruncular approach for reconstruction of medial orbital wall fractures and the combined transcaruncular-transconjunctival approach for reconstruction of large orbital defects involving the medial wall and floor. A retrospective review of the clinical and radiographic data of patients who underwent either a transcaruncular or a combined transcaruncular-transconjunctival approach by a single surgeon for orbital fractures between June 2007 and June 2013 was undertaken. Seven patients with isolated medial wall fractures underwent a transcaruncular approach, and nine patients with combined medial wall and floor fractures underwent a transcaruncular-transconjunctival approach with a lateral canthotomy. Reconstruction was performed using a porous polyethylene implant. All patients with isolated medial wall fractures presented with enophthalmos. In the combined medial wall and floor group, five out of eight patients had enophthalmos with two also demonstrating hypoglobus. The size of the medial wall defect on preoperative computed tomography (CT) scan ranged from 2.6 to 4.6 cm2; the defect size of combined medial wall and floor fractures was 4.5 to 12.7 cm2. Of the 11 patients in whom postoperative CT scans were obtained, all were noted to have acceptable placement of the implant. All patients had correction of enophthalmos and hypoglobus. One complication was noted, with a retrobulbar hematoma having developed 2 days postoperatively. The transcaruncular approach is a safe and effective method for reconstruction of medial orbital floor fractures. Even large fractures involving the orbital medial wall and floor can be adequately exposed and reconstructed with a combined transcaruncular-transconjunctival-lateral canthotomy approach. The level of evidence of this study is IV (case series with pre/posttest).

Resorbable polylactic acid polymer plates in repair of blow-out orbital floor fractures

2020 ◽  
pp. 112067212092800
Author(s):  
Mohamed Esmail Khalil Esmail ◽  
Mohamed Farag Khalil Ibrahiem ◽  
Raafat Mohyeldeen Abdelrahman Abdallah ◽  
Ahmed Mohamed Kamal Elshafei ◽  
Tamer Ismail Gawdat
Keyword(s):  
Polylactic Acid ◽  
Case Series ◽  
Functional Results ◽  
Orbital Floor ◽  
Fracture Plane ◽  
Strong Positive Correlation ◽  
Orbital Floor Fractures ◽  
Changes Over Time ◽  
Orbital Imaging ◽  
Vertical Height

Purpose: To evaluate the use of the resorbable polylactic acid polymer implants (Resorb X) in the management of orbital floor blow-out fractures as regards safety, cosmetic, and functional results. Methods: In a prospective, interventional case series, 22 patients with traumatic blow-out floor fractures underwent lower fornix transconjunctival repair using polylactic acid implant insertion over the defect without fixation. Orbital imaging was done preoperatively, at 1 month and 1 year postoperatively with orbital computed tomography with 2 mm cuts of axial, sagittal, and coronal scans. Outcome measures included the maximum vertical height of the orbit at the fracture plane and its changes over time. Results: At the final follow-up, both limitation of elevation and diplopia improved in 82% of cases, while 63.6% of cases showed improvement of enophthalmos. Radiological restoration of the orbital vertical height was recorded in 100% of cases without implant displacement at 1 month. However, after 1 year, a significant floor bowing was found in 45.5% of cases, which showed a strong positive correlation with preoperative defect size ( r = 0.820). Conclusions: Resorb X mesh plates can be a good option for the safe reconstruction of orbital floor blow-out fractures. Good anatomical and functional results were obtained in small orbital floor defects. Late bowing under pressure may limit their use in medium-sized floor defects.

scholarly journals Orbital Floor Fractures: A Retrospective Review of 45 Cases at a Tertiary Health Care Center

2010 ◽  
Vol 3 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Chun H. Rhim ◽  
Thomas Scholz ◽  
Ara Salibian ◽  
Gregory R.D Evans
Keyword(s):  
Postoperative Complications ◽  
Motor Vehicle ◽  
Care Center ◽  
Orbital Floor ◽  
Porous Polyethylene ◽  
Health Care Center ◽  
Transconjunctival Approach ◽  
Presenting Symptoms ◽  
Fracture Management ◽  
Orbital Floor Fractures

The purpose of this retrospective study was to investigate treatment options for orbital floor fractures at a Level 1 Trauma Center in Southern California. A review of 45 cases of isolated orbital floor fractures treated at the University of California at Irvine between February 2004 and April 2007 was done. Patients were retrospectively analyzed for gender, age, mechanism of injury, associated facial injuries, presenting symptoms, method of treatment, and postoperative complications. Thirty-six male patients and nine female patients were treated. Motor vehicle collision (26/45) was the most common cause of injury, and the mean age of the patients was 35.5 years (range: 15—81 years). Ecchymosis surrounding the orbital tissue was the most common presentation (38/45). Diplopia was present in 8 of 45 patients, with 1 patient requiring urgent decompression for retrobulbar hematoma. Forty-three patients underwent surgical repair; 40 underwent transconjunctival approach with lateral canthotomy; 17 underwent reconstruction with porous polyethylene Medpor (Porex Surgical, Inc., College Park, GA.); and 26 underwent reconstruction with a titanium mesh plate. Immediate postoperative complications included 12 patients with infraorbital numbness, 3 with diplopia, 1 with cellulitis, and 1 with ectropion with a subcilliary approach. Average timing of surgery of our study was 4.94 days (range, 1—20 days). Orbital floor fracture management has changed significantly over the past few decades with the introduction of new internal fixation methods and new materials for reconstructing orbital floor defects. Recommendations for surgical intervention on orbital floor fractures mostly depend on clinical examination and imaging studies. Consequences of inadequate repair of orbital floor fractures can lead to significant facial asymmetry and visual problems. Both porous polyethylene and titanium plates are effective tools for reconstructing the orbital floor. Our review demonstrates that orbital floor fractures can be repaired safely with minimal postoperative complications and confirms that transconjunctival approach to orbital floor is an effective way for exposure and prevention of ectropion that can be seen with other techniques.

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