Prospective study on ocular motility limitation due to orbital muscle entrapment or impingement associated with orbital wall fracture

Injury ◽  
2017 ◽  
Vol 48 (7) ◽  
pp. 1408-1416 ◽  
Author(s):  
Babak Alinasab ◽  
Abdul Rashid Qureshi ◽  
Pär Stjärne
Keyword(s):  
Prospective Study ◽  
Ocular Motility ◽  
Orbital Wall ◽  
Orbital Muscle

scholarly journals New Algorithm for the Management of Orbital Blowout Fracture Based on Prospective Study

2018 ◽  
Vol 11 (4) ◽  
pp. 285-295 ◽  
Author(s):  
Babak Alinasab ◽  
Karl-Johan Borstedt ◽  
Rebecka Rudström ◽  
Michael Ryott ◽  
Abdul Rashid Qureshi ◽  
...  
Keyword(s):  
Prospective Study ◽  
Ct Scan ◽  
Clinical Findings ◽  
Infraorbital Nerve ◽  
Ocular Motility ◽  
Posterior Edge ◽  
Blowout Fracture ◽  
Orbital Wall ◽  
Orbital Rim ◽  
Nonoperated Group

Despite extensive debate and publications in the management of blowout fracture (BOF), there are still considerable differences in the surgeons’ management of BOF due to a lack of reliable evidence-based studies. This article aimed to evaluate which BOF patients require surgical treatment due to functional and/or cosmetic deformities; evaluate which computed tomography (CT) scan findings predict these problems; and provide an algorithm in the management of BOF. Seventy-nine patients with BOF were treated conservatively and followed up prospectively regarding functional and cosmetic deformities for at least 1 year. The patients’ CT scans were analyzed and several measurements were performed. Patients’ symptoms and the clinical findings were correlated to the CT scan measurements. We found visible deformity in 37% of the patients, but only 10% chose to proceed to surgery due to cosmetic deformities. In patients with inferior BOF and a herniation < 1.0 mL, a visible deformity was found when the ratio between fracture and the fractured orbital wall areas was ≥42%, or the total area of the fracture was ≥ 2.3 cm2. In patients with inferior BOF and a herniation ≥ 1.0 mL, a visible deformity was found when the distance from the inferior orbital rim to the posterior edge of the fracture was ≥ 3.0 cm. In patients with inferomedial fracture, a visible deformity was found when the herniation was ≥ 0.9 mL. Diplopia improved significantly and remained in only 3% of the patients in nonoperated group. Hypoesthesia of the infraorbital nerve improved significantly, but 23% of the nonoperated and 50% of the operated patients still experienced loss of sensation at final control. In this prospective study, we found that not only herniated orbital volume but also other CT scan findings in BOF were crucial to predict late visible deformities. Based on these findings, we propose an algorithm for the prediction of late visible deformity with 83% accuracy. There are indications that diplopia without ocular motility disorder is due to edema and we recommend observation as long as the diplopia improves gradually.

scholarly journals Pediatric orbital wall fractures: Prognostic factors of diplopia and ocular motility limitation

PLoS ONE ◽  
2017 ◽  
Vol 12 (11) ◽  
pp. e0184945 ◽  
Author(s):  
Yung Ju Yoo ◽  
Hee Kyung Yang ◽  
Namju Kim ◽  
Jeong-Min Hwang
Keyword(s):  
Prognostic Factors ◽  
Ocular Motility ◽  
Orbital Wall

Management of Displaced Lateral Orbital Wall Fractures Associated with Visual and Ocular Motility Disturbances

1998 ◽  
Vol 102 (4) ◽  
pp. 972-979 ◽  
Author(s):  
Robert B. Stanley ◽  
Bryan S. Sires ◽  
Gerry F. Funk ◽  
Jeffrey A. Nerad
Keyword(s):  
Ocular Motility ◽  
Orbital Wall

Management of Displaced Lateral Orbital Wall Fractures Associated with Visual and Ocular Motility Disturbances

1998 ◽  
Vol 102 (4) ◽  
pp. 972-979 ◽  
Author(s):  
Robert B. Stanley ◽  
Bryan S. Sires ◽  
Gerry F. Funk ◽  
Jeffrey A. Nerad
Keyword(s):  
Ocular Motility ◽  
Orbital Wall

scholarly journals Endoscopic endonasal repair with polyethylene implants in medial orbital wall fractures: A prospective study on 25 cases

2018 ◽  
Vol 46 (2) ◽  
pp. 274-282 ◽  
Author(s):  
Giacomo Colletti ◽  
Alberto Maria Saibene ◽  
Lorenzo Giannini ◽  
Margherita Dessy ◽  
Alberto Deganello ◽  
...  
Keyword(s):  
Prospective Study ◽  
Endoscopic Endonasal ◽  
Orbital Wall ◽  
A Prospective Study ◽  
Medial Orbital Wall

scholarly journals Orbital Wall Reconstruction with Two-Piece Puzzle 3D Printed Implants: Technical Note

2016 ◽  
Vol 9 (1) ◽  
pp. 055-061 ◽  
Author(s):  
Maurice Y. Mommaerts ◽  
Michael Büttner ◽  
Herman Vercruysse ◽  
Lauri Wauters ◽  
Maikel Beerens
Keyword(s):  
The Netherlands ◽  
Three Dimensional ◽  
Technical Note ◽  
Titanium Implants ◽  
Ocular Motility ◽  
Medical Systems ◽  
Large Defect ◽  
Intraoperative 3D Imaging ◽  
Engineering Software ◽  
Orbital Wall

The purpose of this article is to describe a technique for secondary reconstruction of traumatic orbital wall defects using titanium implants that act as three-dimensional (3D) puzzle pieces. We present three cases of large defect reconstruction using implants produced by Xilloc Medical B.V. (Maastricht, the Netherlands) with a 3D printer manufactured by LayerWise (3D Systems; Heverlee, Belgium), and designed using the biomedical engineering software programs ProPlan and 3-Matic (Materialise, Heverlee, Belgium). The smaller size of the implants allowed sequential implantation for the reconstruction of extensive two-wall defects via a limited transconjunctival incision. The precise fit of the implants with regard to the surrounding ledges and each other was confirmed by intraoperative 3D imaging (Mobile C-arm Systems B.V. Pulsera, Philips Medical Systems, Eindhoven, the Netherlands). The patients showed near-complete restoration of orbital volume and ocular motility. However, challenges remain, including traumatic fat atrophy and fibrosis.

scholarly journals Influence of fractures in different inferior orbital wall locations on ocular motility disorders

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Zhi-Gang Li ◽  
Ying Wang ◽  
Jun-Bo Rong ◽  
Li-Juan Lang ◽  
Li-Min Xu ◽  
...  
Keyword(s):  
Ocular Motility ◽  
Motility Disorders ◽  
Orbital Wall ◽  
Ocular Motility Disorders

scholarly journals Periorbital Entrapment in a Minimally Displaced Medial Wall Fracture

2020 ◽  
Vol 6 ◽  
pp. 2513826X2096407
Author(s):  
Kun Hwang
Keyword(s):  
Computed Tomography ◽  
Soft Tissue ◽  
Ct Scan ◽  
Medial Wall ◽  
Ocular Motility ◽  
Orbital Fat ◽  
Orbital Wall ◽  
Medial Orbital Wall

I experienced periorbital entrapment in a minimally displaced medial wall fracture. An 18-year male was hit in the left eye by a fist. He had decreased horizontal ocular motility with pain. Exophthalmometry of both eyes were same. Computed tomography (CT) demonstrated a minimally displaced medial wall fracture with herniation of orbital fat. Decreased horizontal ocular motility and pain persisted until the fifth post-trauma day. On exploration, entrapped soft tissue was found and dissected from the fractured site, but the bony displacement was minimal. After release, the forced duction test became normal and postoperative CT demonstrated reduced herniated orbital fat. In cases of a minimally displaced medial orbital wall fracture, if the patient feels pain while gazing horizontally, precise inspection of the CT scan is needed. If the pain persists for several days, despite the absence of diplopia, periorbital entrapment should be suspected and exploration can be considered.

Endonasal Access to the Orbital Floor for Blowout Fractures

2008 ◽  
Vol 139 (2_suppl) ◽  
pp. P30-P31
Author(s):  
Yasuyuki Hinohira ◽  
Atsushi Shiraishi ◽  
Naohito Hato ◽  
Masahiro Komori
Keyword(s):  
Fracture Site ◽  
Ocular Motility ◽  
Endoscopic Endonasal Approach ◽  
Endonasal Approach ◽  
Endoscopic Endonasal ◽  
Orbital Wall ◽  
Bone Fragments ◽  
Orbital Content ◽  
Supporting Material ◽  
Traction Test

Objective 1) Describe how to endonasally access the inferior orbital wall for the reduction surgery using endoscope. 2) Show the usefulness of the endoscopic endonasal approach for alternative to the current approaches. Methods Between 1997 and 2007, 41 patients with isolated inferior blowout fractures not involving the medial wall underwent surgery. The surgical treatment was determined due to persisting diplopia for 2 to 4 weeks after the trauma. In 38 of the 41 patients the reduction surgery was completed using only the endoscopic endonasal approach. To achieve the endoscopic endonasal reduction surgery, via the middle nasal meatus, septoplasty was supplemented in 7 patients and sub-mucous conchotomy in 36. In 16 patients the inferior antrostomy was additionally required to reach the fracture site. The bone fragments entrapping the orbital content were carefully removed. An ophthalmologist verified the ocular motility improvement by eye traction test. No permanent supporting material except temporary balloon fixation was used. Results No surgical complications were encountered in any of the patients. Postoperatively, diplopia disappeared in 32 of the 35 patients (91.4%) followed over 6 months. No patients complained of postoperative buccal paresthesia or enophthalmos. Conclusions An endoscopic endonasal reduction surgery for isolated blowout fractures has so far been considered as technically difficult. Our procedure to access the inferior orbital wall comprise sinonasal surgery techniques that have been conventionally used. We conclude that the endoscopic endonasal approach can be an alternative to the extranasal methods because of safety and usefulness.

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