Diplopia After Surgical Repair of Orbital Floor Fractures

1996 ◽  
Vol 12 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Brian S. Biesman ◽  
Albert Hornblass ◽  
Richard Lisman ◽  
Melanie Kazlas
2019 ◽  
Vol 35 (06) ◽  
pp. 633-639 ◽  
Author(s):  
Tom Shokri ◽  
Mark Alford ◽  
Matthew Hammons ◽  
Yadranko Ducic ◽  
Mofiyinfolu Sokoya

AbstractFractures of the orbital floor represent a common yet difficult to manage sequelae of craniomaxillofacial trauma. Repair of these injuries should be carried out with the goal of restoring normal orbital volume, facial contour, and ocular motility. Precise surgical repair is imperative to reduce the risk of long-term debilitating morbidity. This article aims to review concepts on the management of orbital floor fractures in the hope of further elucidating perioperative evaluation and decision-making regarding operative intervention.


2018 ◽  
Vol 20 (2) ◽  
pp. 173-175
Author(s):  
Cindi K. Yim ◽  
Rocco Ferrandino ◽  
James Chelnis ◽  
I. Michael Leitman

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.


Materials ◽  
2020 ◽  
Vol 13 (1) ◽  
pp. 206 ◽  
Author(s):  
Otto Steinmassl ◽  
Johannes Laimer ◽  
Vincent Offermanns ◽  
Matthias Wildauer ◽  
Patricia-Anca Steinmassl ◽  
...  

The aim of this retrospective study was to evaluate the clinical outcome of surgical management of small versus large, isolated orbital floor fractures (OFFs) using polyglactin 910/polydioxanone (Ethisorb®). Covering a four-year period (2010–2013), all records concerning midfacial fractures with involvement of the orbit were screened. Isolated fractures of the orbital floor as well as combined injuries of the orbital floor and medial wall that had been treated surgically using polyglactin 910/polydioxanone (Ethisorb®) were included. Patients underwent a preoperative, a postoperative, and a late ophthalmologic assessment. The clinical outcomes of surgically managed small OFFs up to 2 cm2 were statistically analyzed and compared to clinical results in larger defects. The final sample included 61 patients (25 women, 36 men). Fractures up to 2 cm2 were found in 33 patients (54.1%), whereas 28 patients (45.9%) suffered from OFFs larger than 2 cm2. The clinical outcomes did not significantly differ between both sample categories, and statistical analysis showed a power of 0.91 to detect a potentially existing difference. On final examination, 52 patients were free of any clinical symptoms, whereas minor issues were found in seven subjects, and two patients suffered from severe impairment. In conclusion, polyglactin 910/polydioxanone (Ethisorb®) seems to be a suitable material for surgical repair of both small and large OFFs.


2010 ◽  
Vol 3 (4) ◽  
pp. 217-221 ◽  
Author(s):  
Pasquale Piombino ◽  
Giorgio Iaconetta ◽  
Roberto Ciccarelli ◽  
Antonio Romeo ◽  
Alessia Spinzia ◽  
...  

We report our experience with the repair of the orbital floor fractures and present new technical findings. We evaluated 30 subjects with pure blowout fractures treated at the Department of Maxillofacial Surgery of the Federico II University of Naples, Italy, between 2005 and 2007. A preoperative examination by computed tomography scans provided classification of the orbital floor fractures into small and large fractures by measurement of the bone defect to choose the appropriate reconstructive implant materials, resorbable or nonresorbable. The clinical follow-up has been performed at 1 week, 1 month, 3 months, and 6 months. We observed a resolution of preoperative symptoms. The scar was not evident, and there was an absence of postoperative complications. We concluded that the use of resorbable materials for small orbital floor fractures and nonresorbable materials for large orbital floor fractures offers satisfactory results in both functional and aesthetic considerations. Furthermore, the new technical findings allow standardization of the surgical technique to be more accurate, also reducing the economic costs.


Medicines ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 6
Author(s):  
Akash Sivam ◽  
Natalie Enninghorst

The aim of this study is to present a narrative review of the properties of materials currently used for orbital floor reconstruction. Orbital floor fractures, due to their complex anatomy, physiology, and aesthetic concerns, pose complexities regarding management. Since the 1950s, a myriad of materials has been used to reconstruct orbital floor fractures. This narrative review synthesises the findings of literature retrieved from search of PubMed, Web of Science, and Google Scholar databases. This narrative review was conducted of 66 studies on reconstructive materials. Ideal material properties are that they are resorbable, osteoconductive, resistant to infection, minimally reactive, do not induce capsule formation, allow for bony ingrowth, are cheap, and readily available. Autologous implants provide reliable, lifelong, and biocompatible material choices. Allogenic materials pose a threat of catastrophic disease transmission. Newer alloplastic materials have gained popularity. Consideration must be made when deliberating the use of permanent alloplastic materials that are a foreign body with potential body interactions, or the use of resorbable alloplastic materials failing to provide adequate support for orbital contents. It is vital that surgeons have an appropriate knowledge of materials so that they are used appropriately and reduce the risks of complications.


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