Bone grafting for enophthalmos due to a medial orbital wall fracture: case report with 13 year follow-up

ABSTRACT Orbital fractures can cause facial disfigurement and disturbs vision. Medial orbital wall fractures are diagnosed with frequent use of computed tomography (CT) scans in the diagnosis of orbital trauma. Orbital reconstruction plays a challenging role for the surgeons as it comes in a multitude of different forms. We report a case of 45-year male with a history of assault presented with diminution of vision, restricted abduction and diplopia of the left eye. Computed tomography scan showed fracture of the left medial orbital wall fracture and the patient was treated by endoscopic endonasal approach of medial orbital wall reconstruction using septal cartilage. How to cite this article Rajasekar MK, Vivek M, Narendrakumar V. Endoscopic Endonasal Approach of Orbital Medial Wall Reconstruction using Septal Cartilage: A Rare Surgical Case Report. Clin Rhinol An Int J 2015;8(1):30-33.

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Endoscopic Repair of Supraorbital CSF Leaks

Otolaryngology ◽

10.1016/j.otohns.2008.05.245 ◽

2008 ◽

Vol 139 (2_suppl) ◽

pp. P76-P76

Author(s):

Michael Purkey ◽

Alexander G Chiu ◽

Bradford A. Woodworth ◽

James N Palmer

Keyword(s):

Sagittal Plane ◽

Empty Sella ◽

Endoscopic Repair ◽

Orbital Wall ◽

Intracranial Pressures ◽

Skull Base Defect ◽

Medial Orbital Wall ◽

Lateral Defect ◽

Csf Leaks

Objective The supraorbital ethmoid and lateral frontal sinus are difficult to approach endoscopically. Their location, superior and lateral to the orbit, can make access technically challenging. In this study, we examined clinical and anatomical characteristics of patients with supraorbital CSF leaks and encepholeceles and identified specific considerations unique to their management. Methods Retrospective review of patients who underwent repair of supraorbital CSF leaks at our institution from 2003–2007. Results Eight patients were surgically treated. Seven were spontaneous leaks with an associated encepholecele and one was post-craniotomy. The majority of patients were women (5/8), middle-aged (mean: 54.9 years), and had a mean BMI of 42.3 kg/m2. Intracranial pressures were elevated in 6/8 patients and an empty sella was present in each of the 7 patients with a spontaneous leak. Anatomically, 6/8 patients had defects medial to a sagittal plane drawn through the medial orbital wall (mean distance: 4.15 mm) and 2/8 patients had defects lateral to the sagittal plane (mean distance: 8.14 mm). 7/8 were successfully repaired endoscopically and one patient with a lateral defect required conversion to a supra-orbital trephination. All defects were repaired successfully with a mean follow-up of 27.8 months. Conclusions Patients with supraorbital CSF leaks have unique clinical characteristics that include obesity and elevated ICP. Endoscopic repair produces acceptable results with low morbidity. Extension of a skull base defect lateral to a sagittal plane through the medial orbital wall is a technical obstacle to endoscopic repair and may require an adjunctive external approach.

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Ethmoid silent sinus syndrome causing inward displacement of the orbit: case report

The Journal of Laryngology & Otology ◽

10.1017/s0022215109990521 ◽

2009 ◽

Vol 124 (2) ◽

pp. 206-208 ◽

Cited By ~ 9

Author(s):

B McArdle ◽

C Perry

Keyword(s):

Case Report ◽

World Literature ◽

Trauma Surgery ◽

Ethmoid Sinus ◽

Silent Sinus Syndrome ◽

Orbital Wall ◽

Computed Tomography Scans ◽

Significant Pathology ◽

Ethmoidal Bulla ◽

Medial Orbital Wall

AbstractObjective:We describe a previously unreported case of ethmoid silent sinus syndrome.Method:Case report and review of the world literature regarding silent sinus syndrome.Results:A 33-year-old woman developed medial displacement of the left orbital contents in the absence of trauma, surgery or other significant pathology. Imaging showed opacification of the left ethmoid sinus and implosion of the medial orbital wall. Previously reported cases of silent sinus syndrome have all involved the maxillary sinus, with subsequent implosion of the orbital floor. Computed tomography scans of our patient showed wide, flat ethmoidal bulla and surrounding cells, with few horizontal bony septae reinforcing the area of collapse.Conclusion:This case represents the first report of ethmoid silent sinus syndrome. We argue that, in anatomically susceptible individuals, the silent sinus syndrome can present due to chronic ethmoidal sinusitis.

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Pyrolytic Carbon Hemiarthroplasty for Avascular Necrosis of the Metacarpal Head: A Case Report

The Journal of Hand Surgery (Asian-Pacific Volume) ◽

10.1142/s2424835518720086 ◽

2018 ◽

Vol 23 (01) ◽

pp. 140-143 ◽

Cited By ~ 4

Author(s):

Kahyun Kim ◽

Hyun Sik Gong ◽

Goo Hyun Baek

Keyword(s):

Case Report ◽

Avascular Necrosis ◽

Bone Grafting ◽

Pyrolytic Carbon ◽

Rare Entity ◽

Surgical Interventions ◽

Metacarpal Head

Avascular necrosis of the metacarpal head is a rare entity. Surgical interventions, such as curettage, bone-grafting, and osteotomy, have been reported in symptomatic patients. We present a patient who underwent pyrolytic carbon hemiarthroplasty of the metacarpal head and had satisfactory outcomes at 1-year follow-up.

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A novel individual reconstruction of a medial orbital wall blow-out fracture using a bone graft molded intraoperatively using a 3-D model: a case report

Oral and Maxillofacial Surgery Cases ◽

10.1016/j.omsc.2016.05.001 ◽

2016 ◽

Vol 2 (2) ◽

pp. 19-21 ◽

Cited By ~ 2

Author(s):

P.J. Meier ◽

C. Jadhav ◽

D.A. Morrison ◽

A.J. Hayes ◽

S. Cunneen

Keyword(s):

Case Report ◽

Bone Graft ◽

Orbital Wall ◽

Medial Orbital Wall ◽

D Model

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Isolated Medial Orbital Wall Fracture Associated with Enophthalmos in a Paediatric Patient: An Unusual Presentation

Case Reports in Ophthalmology ◽

10.1159/000486275 ◽

2018 ◽

Vol 9 (1) ◽

pp. 132-137

Author(s):

Panagiotis Giannakouras ◽

Georgios Pollalis ◽

Efthymia Tsina

Keyword(s):

Paediatric Patient ◽

Dramatic Improvement ◽

Intravenous Treatment ◽

Orbital Wall ◽

Nerve Paresis ◽

Ophthalmologic Examination ◽

The Right ◽

Medial Orbital Wall ◽

Sixth Nerve

Purpose: To report a case of isolated medial orbital wall fracture with enophthalmos in a paediatric patient and describe the clinical presentation and findings by means of computed tomography (CT) of the head and eyes. Methods: We looked at the patient’s medical and ophthalmologic history, and an ophthalmologic examination and a CT of the head were performed at baseline. Results: A 14-year-old boy was admitted to the emergency department of our institution with ecchymosis of his right eyelids secondary to a sport accident. Physical examination revealed a moderate limitation of upgaze without diplopia. CT showed a medial orbital wall fracture without haemorrhage and a gross accumulation of air in the right eyelid with pressure exertion over the right globe and enophthalmos. The patient was treated conservatively with oral antibiotics and steroids showing dramatic improvement within 1 week. Enophthalmos and periorbital emphysema were completely resolved within 3 months after the accident as indicated by CT. Conclusions: We conclude that surgical intervention and intravenous treatment are not warranted in similar cases of medial orbital wall fracture. Medical history, clinical and paraclinical evaluations, and a regular follow-up, including CT, are needed though to avoid complications such as painful abduction, horizontal diplopia, pseudo sixth nerve paresis, or pseudo Duane.

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