scholarly journals ORBITAL FLOOR RECONSTRUCTION WITH TRANS-ANTRAL APPROACH USING ENDOSCOPE

2020 ◽  
Vol 6 (1) ◽  
pp. 40-42
Author(s):  
RISHABH GIRI ◽  
Vikas Kunwar Singh ◽  
Ruchika Tiwari ◽  
Gaurang Thanvi
Keyword(s):  
Posterior Part ◽  
Good Alternative ◽  
Conventional Approach ◽  
Orbital Floor ◽  
Treatment Modalities ◽  
Orbital Fractures ◽  
Blowout Fracture ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction ◽  
Endoscopic Assistance

Background and objective: Orbital floor fractures are very common in current day to day scenario. Till date different treatment modalities have been tried to reconstruct the orbital fractures. Conventionally various transorbital approaches have been used. But in cases where there is involvement of posterior part of orbit there is drawback of incomplete accessibility. To overcome this endoscopic assistance tends to get mandatory through trans-antral approach for better visualization, providing a good alternative to conventional approach. Case Report: A 55-year-old male patient with pure blowout fracture along with persistent diplopia and enophthalmos was operated with sub tarsal approach along with trans antral approach using endoscope. Result: The post-surgical results were satisfactory in respect to correction of diplopia and enophthalmos. Conclusion: Conventional approach assisted with endoscope provides a new method of managing Orbital floor fractures improving treatment outcomes.

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.

scholarly journals The Dilemma of Reconstructive Material Choice for Orbital Floor Fracture: A Narrative Review

Medicines ◽  
2022 ◽  
Vol 9 (1) ◽  
pp. 6
Author(s):  
Akash Sivam ◽  
Natalie Enninghorst
Keyword(s):  
Disease Transmission ◽  
Narrative Review ◽  
Orbital Floor ◽  
Alloplastic Materials ◽  
Complex Anatomy ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction ◽  
Material Choice ◽  
Properties Of Materials ◽  
Catastrophic Disease

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.

scholarly journals Surgical Approach to Orbital Floor Fractures: Comparing Complication Rates Between Subciliary and Subconjunctival Approaches

2020 ◽  
Vol 13 (1) ◽  
pp. 45-48
Author(s):  
Joel A. Bronstein ◽  
William J. Bruce ◽  
Fadi Bakhos ◽  
Dalia Ishaq ◽  
Cara J. Joyce ◽  
...  
Keyword(s):  
Surgical Approach ◽  
Complication Rate ◽  
Patient Characteristics ◽  
Orbital Floor ◽  
Study Patient ◽  
Complication Rates ◽  
Postoperative Complication Rate ◽  
Corneal Injury ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction

Background: There are multiple approaches to repairing orbital floor fractures. This study compares the postoperative complications of the subciliary and transconjunctival approaches. Methods: The electronic medical records from 2 hospitals were screened for CPT codes associated with orbital floor reconstruction. A total of 184 patients were identified and included in the study. Patient characteristics and complications were compared by surgical approach. Results: Of the 184 patients, 82 (44.6%) were in the subciliary group and 102 (55.4%) were in the transconjunctival group. The overall postoperative complication rate was 25.5%. The most common of these were diplopia (11.4%), corneal injury (7.1%), proptosis (5.4%), and enopthalmos (4.9%). The complication rate was not statistically significant between the 2 groups. Conclusion: Subciliary and transconjunctival approaches to orbital floor repair are equally safe. This study is limited by a smaller sample size, and a larger study will likely be necessary to fully address this question.

scholarly journals A Protocol to Reduce Interobserver Variability in the Computed Tomography Measurement of Orbital Floor Fractures

2015 ◽  
Vol 8 (4) ◽  
pp. 289-298 ◽  
Author(s):  
ChuanHan Ang ◽  
JinRong Low ◽  
JiaYi Shen ◽  
Elijah Zheng Yang Cai ◽  
Eileen Chor Hoong Hing ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Ct Scan ◽  
Surface Area ◽  
Interobserver Variability ◽  
Intraclass Correlation ◽  
Orbital Floor ◽  
Orbital Fracture ◽  
Orbital Fractures ◽  
Fracture Detection ◽  
Orbital Floor Fractures

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.

scholarly journals Surgical treatment of orbital floor blowout fracture in children: A case report

2015 ◽  
Vol 72 (9) ◽  
pp. 841-844 ◽  
Author(s):  
Sasa Tabakovic ◽  
Ivana Ilic-Dimitrijevic
Keyword(s):  
Case Report ◽  
Surgical Treatment ◽  
Functional Results ◽  
Orbital Floor ◽  
Traumatic Lesion ◽  
Blowout Fracture ◽  
Orbital Floor Fracture ◽  
Aesthetic Appearance ◽  
Orbital Floor Reconstruction ◽  
Craniofacial Complex

Introduction. Orbital floor blowout fracture is a common traumatic lesion of the craniofacial complex, but rarely in children population, consequently representing challenge in surgical treatment. Timely diagnosis and surgical treatment prevent the probability of the occurrence of the functional complications. Case report. We presented surgical treatment of on 8-year-old girl with a blowout orbital floor fracture one month after the injury. The predominant symptoms were: ocular bulb motility disorder with consecutive strabismus and double vision. Orbital floor reconstruction was made by an autogenous mandibular symphyseal graft. A year after the orbital floor reconstruction additional correction of strabismus was performed due to functional disorder of the bulbomotor muscles. Conclusion. Delayed surgical treatment of blowout orbital floor fracture in children leads to unsatisfactory functional results in the majority of cases. In such a situation surgical correction of strabismus is necessary in order to obtain functionally quality vision and satisfactory aesthetic appearance.

scholarly journals STRABISMUS MANAGEMENT AFTER ORBITAL BLOWOUT FRACTURE

2021 ◽  
pp. 36-40
Author(s):  
Reena Gupta ◽  
Chekitaan Singh ◽  
Rohan Madan ◽  
Suma Ganesh
Keyword(s):  
Road Traffic ◽  
Motor Nerve ◽  
Rectus Muscle ◽  
Orbital Floor ◽  
Inferior Rectus ◽  
Presumptive Diagnosis ◽  
Blowout Fracture ◽  
Post Surgery ◽  
Orbital Floor Fractures ◽  
Inferior Rectus Muscle

Orbital floor fractures (OBF) account for 40% of mid-facial injuries and are therefore the most common of all trauma injuries in this region. The post-treatment complication that often follows orbital floor repair is residual diplopia or 1 persistent diplopia and is seen in 86% of the OBF cases. The causes for persistent diplopia can be varied and is often related to the degree of inflammation, trauma to 2 musculature, fat or nerves and surgical timing. Some of the common causes of the same are - malpositioning of the globe, fibrosis of the inferior fibro fatty muscular complex following trauma, direct damage to an extraocular muscle (commonly inferior rectus muscle), local injury to a motor nerve, ischemia (or compartment syndrome), iatrogenic damage during reconstructive surgery or entrapment under improperly placed alloplastic material. Our case report mentions a rare case of persistent vertical diplopia even after successful repair of orbital blowout fracture. A 15-year-old male patient following a road traffic accident presented with persistent headache and vertical diplopia. The patient was evaluated by a oral maxillofacial surgeon and a presumptive diagnosis of a case of large orbital floor fracture with entrapment of inferior rectus muscle was made which was confirmed on CT Scan. He was managed surgically by reduction of the fracture and fixation with a titanium mesh. 2 weeks post-surgery he reported to the squint clinic with complaints of persistent double vision. On comprehensive ocular examination, it was found that patient had vertical diplopia with limitation of infraduction in the left eye with negative FDT, on re-evaluation of MRI scans with 1 mm cuts, a partial left inferior rectus tear was seen and documented as the cause of persistent diplopia. Patient was treated conservatively by prescribing prismatic glasses with fusional exercises. After 6 months of follow up, the patient was relieved of diplopia in primary position but there was a residual hypotropia in downgaze for which he was prescribed prisms only for downgaze.

Endoscopic-Assisted Orbital Floor Reconstruction: the First Two Cases in Vietnam

2018 ◽  
Vol 8 (3) ◽  
Author(s):  
Trung Trực Vũ ◽  
Mai Anh Bui
Keyword(s):  
Endoscopic Surgery ◽  
University Hospital ◽  
Orbital Floor ◽  
Facial Trauma ◽  
Orbital Fracture ◽  
Viet Nam ◽  
Orbital Fractures ◽  
Surgical Indications ◽  
Orbital Floor Reconstruction

Tóm tắt Vỡ xương ổ mắt là một bệnh cảnh phối hợp trong chấn thương hàm mặt và chấn thương sọ mặt. Các biến chứng thường gặp nhất là lõm ổ mắt, song thị và kẹt cơ vận nhãn để lại ảnh hưởng nặng nề cả về chức năng và tâm lý. Điều trị có thể được thực hiện bởi nhiều chuyên khoa, tuy nhiên kỹ thuật và chỉ định vẫn còn nhiều bàn cãi. Tác giả thông báo hai trường hợp đầu tiên ở Việt Nam được tạo hình sàn ổ mắt sau chấn thương với nội soi hỗ trợ tại Bệnh viện Hữu nghị Việt Đức năm 2016. Abstract Orbital fractures are a combination of facial jaw injuries and face skull injuries. The most common complications are enophthalmos, diplopia and muscle entrapment that leave a bad effect on both funtion and psychology. Treatment can be done by various specialists, howeverthe technique and surgical indications are still controversial. The authors report the first two cases in Vietnam which were reconstructed of the orbital floor with endoscopic-assisted at VietDuc University Hospital in 2016. Keyword: Orbital fracture, facial trauma, enophthalmos, orbital floor reconstruction, endoscopic surgery.

scholarly journals Orbital Floor Fractures: Management Protocols

2010 ◽  
Vol 3 (1) ◽  
pp. 1-4
Author(s):  
Hemant Chopra ◽  
Kapil Dua ◽  
Neha Chopra ◽  
Vikrant Mittal ◽  
Rajinder Mittal
Keyword(s):  
Maxillofacial Trauma ◽  
Orbital Floor ◽  
Orbital Fractures ◽  
Treatment Timing ◽  
Orbital Floor Fractures ◽  
Materials Used ◽  
Methods Of Treatment ◽  
Functional Problems

Abstract Orbital fractures commonly occur in maxillofacial trauma causing enophthalmos and diplopia. If not properly managed the cosmetic and functional problems can virtually become untreatable. In recent years, management of these fractures has been standardized with special emphasis on methods of treatment, timing and materials used for reduction.

scholarly journals ORBITAL FLOOR RECONSTRUCTION WITH TITANIUM MESH;

2014 ◽  
Vol 21 (03) ◽  
pp. 575-579
Author(s):  
Muhammad Usman Khalid ◽  
Arshad Mahmood Malik ◽  
Omer Sefvan Janjua
Keyword(s):  
Study Design ◽  
Complication Rate ◽  
Maxillofacial Surgery ◽  
Male Gender ◽  
Orbital Floor ◽  
Titanium Mesh ◽  
No Donor ◽  
Orbital Floor Fractures ◽  
Orbital Floor Reconstruction ◽  
Infraorbital Rim

Objective: To determine the outcome of orbital floor reconstruction with titaniummesh in terms of diplopia, enophthalmos, dystopia and infection etc. Study design: Descriptivecase series. Place & duration of study: Department of Oral & Maxillofacial Surgery, PunjabMedical College / Allied Hospital Faisalabad. One and Half year from 01-10-12 to 31-03-14.Material and Method: Twenty two patients clinically and radiographically having defect in theorbital floor due to trauma were included in the study. Titanium mesh was used to reconstruct theorbital floor through infraorbital rim incision and secured in place with 5mm micro screws. Thevariables to be analyzed were diplopia, enophthalmos, orbital dystopia and infection. Results: Inour study male gender predominates over female 20/22. Mean age of patients is 29.36 years ±5.21. Diplopia persisted in 2/10 (20%) patients. Enophthalmos persisted in 7/18 (38.8%) patients.dystopia persisted in ¼ (25%) patients. Infection didn’t develop in any of our patient (0%). Visualacuity was not affected in any of the patient (0%). Conclusions: Titanium mesh is a suitablematerial for reconstruction of orbital floor fractures with little complication rate and no donor sitemorbidity.

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