scholarly journals Blood Collection within the Maxillary Sinus following Orbital Fracture Repair: The Impact of Mesh Implants and Drains

2019 ◽  
Vol 12 (3) ◽  
pp. 167-173
Author(s):  
Jacob T. Cox ◽  
Jing Tian ◽  
Shannath Merbs ◽  
Nicholas R. Mahoney

This article aimed to assess the effects of (1) mesh (e.g., uncoated anatomic titanium plates) versus non-mesh (e.g., porous polyethylene-coated titanium sheets) implant materials and (2) drain placement on the accumulation of blood within the maxillary sinus following surgical repair of orbital floor fractures. Ninety-two patients who received orbital floor fracture repair between 2008 and 2014 were selected, with equal case numbers between categories: (1) non-mesh implant, without drain; (2) non-mesh implant, with drain; (3) mesh implant, without drain; and (4) mesh implant, with drain. Lesion-mapping software was used to measure blood and sinus volumes in postoperative computed tomographic images. Average postoperative maxillary sinus filling was 49% ± 29%. Average sinus filling was similar between mesh and non-mesh implant materials; this was true in cases with a drain (45 vs. 40%, respectively) and without (57 vs. 52%, respectively). Orbital drain placement was associated with a significant reduction ( p = 0.048) in maxillary sinus filling of 12%. Mesh and non-mesh implant materials allow for similar drainage of orbital blood into the maxillary sinus postoperatively. In the majority of cases, space is available within the maxillary sinus to allow for drainage of orbital blood. Intraoperative drain placement is associated with reduced blood pooling within the maxillary sinus, suggesting it allows for drainage of orbital blood to the outside world.

2020 ◽  
Vol 9 (5) ◽  
pp. 464-467
Author(s):  
Ernest Cavalcante Pouchain ◽  
Vanessa Anastacio Pimentel ◽  
Roque Soares Martins Neto ◽  
Francisco Wylliego de Holanda Maciel ◽  
Kelvin Saldanha Lopes ◽  
...  

Os traumas de face ocorrem por forças externas lesionando o corpo, podendo eles ser locais, gerais ou concomitantes. A etiologia do traumatismo orbitário é diversificada como: quedas, queimaduras e agressões, sendo considerada uma das principais causas de morte no mundo de acordo com Organização Mundial da Saúde (OMS). As fraturas faciais podem se dividir em fraturas dos terço superior, terço médio e terço inferior. As fraturas do tipo Blow-outmantêm as margens orbitais integra, envolvendo apenas parede orbital inferior e ou média. Diplopia e enoftalmia são complicações bem características de traumas orbitais. O objetivo do artigo é identificar as principais lesões ocasionadas por fraturas orbitárias e apontar o diagnóstico e tratamento das lesões. Trata-se de uma revisão de literatura do tipo descritiva, com os dados colhidos nas bases de dados PubMed, SciElo, Lilacs, Google Acadêmico, selecionando artigos entre o ano de 2008 – 2018, de língua inglesa, portuguesa e espanhola, disponíveis para download nas bases de dados citadas. Os exames de imagem como a Tomografia Computadorizada é de suma importância para o diagnóstico devido seu detalhamento. Alguns sinais clínicos são: diplopia, enoftalmia, hipoftalmia ou mobilidade muscular ocular prejudicada. O tratamento ainda varia muito entre os cirurgiões.Descritores: Diplopia; Fraturas Ósseas; Órbita; Traumatismo do Nervo Abducente; Nervo Óptico.ReferênciasRamos JC, Almeida MLD, Alencar YCG, de Sousa Filho LF, Figueiredo CHMC, Almeida MSC. Estudo epidemiológico do trauma bucomaxilofacial em um hospital de referência da Paraíba. Rev Col Bras Cir. 2018;45(6):e1978.Affonso PRA, Cavalcanti MA, Groisman S, Gandelman I. Etiologia de trauma e lesões faciais no atendimento pré – hospitalar no Rio de Janeiro. Rev UNINGÁ. 2010;23(1):23-34.Scolari N, Heitz C. Protocolo de tratamento em fraturas orbitárias. RFO UPF. 2012;17(3):365-69.Polligkeit J, Grimm M, Peters JP, Cetindis M, Krimmel M, Reinert S. Assessment of indications and clinical outcome for the endoscopy-assisted combined subciliary/transantral approach in treatment of complex orbital floor fractures. J Craniomaxillofac Surg. 2013;41(8):797-802.Mendonça JCG, Freitas GP, Lopes HB, Nascimento VS. Tratamento de fraturas complexas do terço médio da face: relato de caso. Rev Bras Cir Craniomaxilofac 2011;14(4):221-24.Jung H, Byun JY, Kim HJ, Min JH, Park GM, Kim HY, Kim YK, Cha J, Kim ST. Prognostic CT findings of diplopia after surgical repair of pure orbital blowout fracture. J Craniomaxillofac Surg. 2016;44(9):1479-84.Ellis E 3rd, Perez D. An algorithm for the treatment of isolated zygomatico-orbital fractures. J Oral Maxillofac Surg. 2014;72(10):1975-83.Nilsson J, Nysjö J, Carlsson AP, Thor A. Comparison analysis of orbital shape and volume in unilateral fractured orbits. J Craniomaxillofac Surg. 2018;46(3):381-87.  Yu DY, Chen CH, Tsay PK, Leow AM, Pan CH, Chen CT. Surgical Timing and Fracture Type on the Outcome of Diplopia After Orbital Fracture Repair. Ann Plast Surg. 2016;76 Suppl 1:S91-5.Morotomi T, Iuchi T, Hashimoto T, Sueyoshi Y, Nagasao T, Isogai N. Image analysis of the inferior rectus muscle in orbital floor fracture using cine mode magnetic resonance imaging. J Craniomaxillofac Surg. 2015;43(10):2066-70.He Y, Zhang Y, An JG. Correlation of types of orbital fracture and occurrence of enophthalmos. J Craniofac Surg. 2012;23(4):1050-53. Roth FS, Koshy JC, Goldberg JS, Soparkar CN. Pearls of orbital trauma management. Semin Plast Surg. 2010;24(4):398-410. Palmieri CF Jr, Ghali GE. Late correction of orbital deformities. Oral Maxillofac Surg Clin North Am. 2012;24(4):649-63. Tavares SSS, Tavares GR, Oka SC, Cavalcante JR, Paiva MAF. Fraturas orbitárias: revisão de literatura e relato de caso. Rev Cir Traumatol Buco-Maxilo-Fac. 2011;11(2):35-42.Long JA, Gutta R. Orbital, periorbital, and ocular reconstruction. Oral Maxillofac Surg Clin North Am. 2013;25(2):151-66.Wolff J, Sándor GK, Pyysalo M, Miettinen A, Koivumäki AV, Kainulainen VT. Late reconstruction of orbital and naso-orbital deformities. Oral Maxillofac Surg Clin North Am. 2013;25(4):683-95.  Dean A, Heredero S. Alamillos F.J, García-García B. Aplicación clínica de la planificación virtual y la navegación en el tratamiento de las fracturas del suelo de la órbita. Rev Esp Cir Oral Maxilofac. 2015; 37(4):220-28.Damasceno NAP, Damasceno EF. raumatic orbital fracture with intact ocular globe displacement into the maxillary sinus. Rev bras oftalmol. 2010;69(1):52-4.


2018 ◽  
Vol 29 (4) ◽  
pp. e421-e426 ◽  
Author(s):  
Omri Emodi ◽  
Saleh Nseir ◽  
Dekel Shilo ◽  
Hanna Srouji ◽  
Adi Rachmiel

2015 ◽  
Vol 8 (4) ◽  
pp. 289-298 ◽  
Author(s):  
ChuanHan Ang ◽  
JinRong Low ◽  
JiaYi Shen ◽  
Elijah Zheng Yang Cai ◽  
Eileen Chor Hoong Hing ◽  
...  

Orbital fracture detection and size determination from computed tomography (CT) scans affect the decision to operate, the type of surgical implant used, and postoperative outcomes. However, the lack of standardization of radiological signs often leads to the false-positive detection of orbital fractures, while nonstandardized landmarks lead to inaccurate defect measurements. We aim to design a novel protocol for CT measurement of orbital floor fractures and evaluate the interobserver variability on CT scan images. Qualitative aspects of this protocol include identifying direct and indirect signs of orbital fractures on CT scan images. Quantitative aspects of this protocol include measuring the surface area of pure orbital floor fractures using computer software. In this study, 15 independent observers without clinical experience in orbital fracture detection and measurement measured the orbital floor fractures of three randomly selected patients following the protocol. The time required for each measurement was recorded. The intraclass correlation coefficient of the surface area measurements is 0.999 (0.997–1.000) with p-value < 0.001. This suggests that any observer measuring the surface area will obtain a similar estimation of the fractured surface area. The maximum error limit was 0.901 cm2 which is less than the margin of error of 1 cm2 in mesh trimming for orbital reconstruction. The average duration required for each measurement was 3 minutes 19 seconds (ranging from 1 minute 35 seconds to 5 minutes). Measurements performed with our novel protocol resulted in minimal interobserver variability. This protocol is effective and generated reproducible results, is easy to teach and utilize, and its findings can be interpreted easily.


1999 ◽  
Vol 57 (4) ◽  
pp. 399-403 ◽  
Author(s):  
Noah A Sandler ◽  
Ricardo L Carrau ◽  
Mark W Ochs ◽  
Randall L Beatty

1985 ◽  
Vol 38 (1) ◽  
pp. 113-115 ◽  
Author(s):  
Lawrence N. Gray ◽  
Ramasamy Kalimuthu ◽  
Bangalore Jayaram ◽  
Nolan Lewis ◽  
Manutcher Sohaey

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