Analysis of the Results of Reconstructive and Restorative Operations in Post-Traumatic Orbital Defects by Computer Simulation

Treatment of patients with post-traumatic orbital defects is relevant problem of ophthalmology and maxillofacial surgery. Residual diplopia or dislocation of the eyeball leads to disability, social maladaptation and development of psychoemotional disorders in patients. In this paper, we present an evaluation of treatment of patients with posttraumatic orbital wall defects based on the retrospective comparative analysis of CT data by computer simulation before and after reconstruction. When comparing the volume of the injured orbits before and after the operation (average volume difference was 2.7 ± 0.9 cm3), a significant improvement was found in terms of recovery of the orbital volume. The factors inﬂuencing the treatment effectiveness were determined based on the calculation of the volume of the orbits on the healthy and injured side in the software environment before and after the reconstruction. The causes of the detected cases of incomplete recovery of the orbital volume were analyzed. The solution to the problem of restoring the orbital volume is in the plane of restoring the geometry of the orbit because previous adaptation of the shape of the standard plate to its anatomical structure with overlapping defect on the stereolithographic model provided the best end result. Conclusions. Personalized adaptation of the implants to the shape of the orbit or individual production thereof can increase the accuracy of the orbital volume restoration, which can increase the effectiveness of eliminating complications such as enophthalmos and diplopia. The effectiveness of treatment of post-traumatic orbital defects by traditional methods directly depends on the severity of the damage, the degree of which determines the magnitude of the change in the orbital volume. However, the greater is the volume of the orbit changes as a result of the injury, the worse is the prognosis for its recovery. Development of the ways to individualize implants and evaluate their effectiveness is an important area for further research. Keywords: post-traumatic orbital defects, reconstructive surgery, computer simulation.

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Orbital proportion indices and microlipografting for correction of secondary post-traumatic enophthalmos

Kazan medical journal ◽

10.17816/kmj2020-139 ◽

2020 ◽

Vol 101 (1) ◽

pp. 139-144

Author(s):

N N Sultanova ◽

M S Alieva

Keyword(s):

Maxillofacial Surgery ◽

Three Dimensional ◽

Circular Muscle ◽

Aesthetic Result ◽

Orbital Wall ◽

Simulation Based ◽

Post Traumatic ◽

Orbital Height ◽

Medical University

Aim. Aesthetic rehabilitation of patients with secondary post-traumatic enophthalmos. Methods. From 2013 to 2018, 14 patients with secondary post-traumatic enophthalmos were treated at the maxillofacial surgery clinic of the Azerbaijan Medical University. All patients underwent reconstruction of the damaged orbital wall, so its bone volume was restored. However, in the postoperative period, a deficiency of the orbital soft tissue was noted. In preparation for the surgery, all patients underwent the following types of examination: three-dimensional computed tomography, photographic, anthropometric measurements with the determination of proportional indices and computer simulation. Based on the data obtained, the orbital proportion indices were calculated: intercanthal index (en-en)100/(ex-ex); orbital protrusion index (ex-ex)100/(ex-en,rl)+(en-en); orbital width index (ex-en,l)100/(en-en); eye fissure (palpebral) index (ps-pi, l)100/(ex-en,l); orbital index (os-or,l)100/(ex-en,l); eyebrow orbital height index (os-or,l)100/(sci-or,l); index of vertical orbital contour (os-or,l)100/(ps-os+pi-or)+(ps-pi); eyelid height index (pi-or,l)100/(ps-os,l). Microlipografting was performed according to the Coleman method with modification by T. Marten. Fat aspiration was performed with a blunt cannula with a diameter of 2.12.4 mm and a 10 ml syringe, without anesthetic administration. Prior to microlipografting, fibrotic cords between the skin and underlying tissues were dissected using a sharp needle and a V-shaped cannula. Microlipografting was performed using microcannulas of 0.71.1 mm. The fat microtransplant was introduced in two layers: under the circular muscle of the eye and subperiostally in the orbit. Results. In 11 cases, with an unexpressed form of secondary post-traumatic enophthalmos, a good aesthetic result was recorded. In 3 patients with a pronounced form of enophthalmos, a satisfactory aesthetic result was obtained; in these cases, repeated microlipografting was carried out. Conclusion. Microlipografting based on the calculation of the orbit proportions indices during rehabilitation of patients with secondary post-traumatic enophthalmos is a minimally invasive and effective procedure.

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Intraoperative Navigation and Cone Beam Computed Tomography for Restoring Orbital Dimensions: A Single-Center Experience

Craniomaxillofacial Trauma & Reconstruction ◽

10.1177/1943387520904869 ◽

2020 ◽

Vol 13 (2) ◽

pp. 84-92 ◽

Cited By ~ 1

Author(s):

Brecht De Cuyper ◽

Johan Abeloos ◽

Gwen Swennen ◽

Lies Pottel

Keyword(s):

Computed Tomography ◽

Cone Beam Computed Tomography ◽

Normal Function ◽

Added Value ◽

Cone Beam ◽

Orbital Surgery ◽

Postoperative Function ◽

Orbital Volume ◽

Post Traumatic ◽

Orbital Defects

Background: Correction of post-traumatic orbital defects remains a challenge for the maxillofacial surgeon. We examined the added value of combined intraoperative (IO) navigation and IO cone beam computed tomography (CBCT). Materials and Methods: A retrospective cohort study was performed in all consecutive patients requiring unilateral post-traumatic orbital surgery between January 2012 and December 2018. Patients were divided into 3 groups: IO navigation (NAV), IO-CBCT (CBCT), and IO navigation with IO-CBCT (NAV-CBCT). A detailed description of our workflow is provided. Volumetric comparison of the operated orbit to the contralateral orbit was made with Brainlab. Results: Of the 81 cases, 22 patients were included (12 males/10 females) with a mean age of 51 years. Three patients were assigned to NAV, 6 to CBCT, and 13 to NAV-CBCT. The reconstructed orbital volume did not significantly differ from the contralateral orbital volume within the 3 groups. The mean difference between the contralateral and the operated orbit was 3.05 cm3, 3.72 cm3, and 1.47 cm3 for NAV, CBCT, and NAV-CBCT, respectively, where only NAV-CBCT showed a significant smaller volumetric difference in comparison to CBCT alone. Gender or age did not correlate with difference in orbital volume. Normal function and aesthetics was seen at 6 weeks postoperative in 0 of 3, 6of 6, and 6 of 13 patients of the NAV, CBCT, and NAV-CBCT, respectively. Conclusion: Orbital defects can be treated effectively using IO navigation. Although our data could not demonstrate a significant added value of IO-CBCT in cases where IO navigation was used based on volumetric difference alone, the combination of IO-CBCT and IO navigation seems to give the best results considering both volumetric difference and postoperative function and aesthetics. Confirmation in a prospective, randomized trial with a larger sample size is required.

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Orbital reconstruction for tumor-associated proptosis: quantitative analysis of postoperative orbital volume and final eye position

Journal of Neurosurgery ◽

10.3171/2018.12.jns181385 ◽

2020 ◽

Vol 132 (3) ◽

pp. 927-932 ◽

Cited By ~ 3

Author(s):

Robert S. Heller ◽

Carlos A. David ◽

Carl B. Heilman

Keyword(s):

Internal Control ◽

Tumor Invasion ◽

Functional Disability ◽

Superior Orbital Fissure ◽

Orbital Reconstruction ◽

Orbital Volume ◽

Radiographic Measurements ◽

Orbital Wall ◽

Before And After ◽

Frontal Processes

OBJECTIVESurgical resection of sphenoid wing tumors and intraorbital pathology carries the dual goal of appropriately treating the target pathology as well as correcting proptosis. Residual proptosis following surgery can lead to cosmetic and functional disability. The authors sought to quantitatively assess the effect of orbital volume before and after reconstruction to determine the optimal strategy to achieve proptosis correction.METHODSAll surgeries involving orbital wall reconstruction for orbital or intracranial pathology that preoperatively resulted in proptosis between 2007 and 2017 were reviewed. Proptosis was measured by the exophthalmos index (EI): the ratio of the distance of the anterior limit of each globe to a line drawn between the anterior limit of the frontal processes of the zygomas, comparing the pathological eye to the normal eye. Postoperative radiographic measurements were taken at least 60 days after surgery to allow surgical swelling to abate. The orbit contralateral to the pathology was used as an internal control for normal anatomical orbital volume. Cases with preoperative EI < 1.10, orbital exenteration, or enucleation were excluded.RESULTSTwenty-three patients (16 females and 7 males, with a mean age of 43.6 ± 22.8 years) were treated surgically for tumor-associated proptosis. Nineteen patients harbored meningiomas (11 en-plaque; 8 sphenoid wing), and one patient each harbored an orbital schwannoma, glomangioma, arteriovenous malformation, or cavernous hemangioma. Preoperative EI averaged 1.28 ± 0.10 (range 1.12–1.53). Median time to postoperative imaging was 19 months. Postoperatively, the EI decreased to a mean of 1.07 ± 0.09. Greater increases in size of the reconstructed orbit were positively correlated with greater quantitative reductions in proptosis (p < 0.01). Larger volume of soft tissue pathology was also associated with achieving greater proptosis correction (p < 0.01). Residual exophthalmos (defined as EI > 1.10) was present in 8 patients, while reconstruction in 2 patients resulted in clinically asymptomatic enophthalmos (defined as EI < 0.95). Tumor invasion into the superior orbital fissure sinus was associated with residual proptosis (p = 0.04).CONCLUSIONSProptosis associated with intracranial and orbital pathology represents a surgical challenge. The EI is a reliable and quantitative assessment of proptosis. For orbital reconstruction in cases of superior orbital fissure involvement, surgeons should consider rebuilding the orbit at slightly larger than anatomical volume.

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Trends in Craniofacial Injuries Associated with the Introduction of Electric Scooter Sharing Services

FACE ◽

10.1177/2732501621992441 ◽

2021 ◽

pp. 273250162199244

Author(s):

Elizabeth M. Boudiab ◽

Thomas D. Zaikos ◽

Christopher Issa ◽

Kongkrit Chaiyasate ◽

Stephen M. Lu

Keyword(s):

Maxillofacial Surgery ◽

Age Groups ◽

Injury Surveillance System ◽

Patient Demographics ◽

Time Period ◽

Electric Scooter ◽

Before And After ◽

Trends Over Time ◽

Patterns Of Injury ◽

Craniofacial Fractures

Electric scooters are an increasingly common and convenient mode of transportation worldwide and have effectively revolutionized the shared micromobility industry. As electric scooter sharing companies have increased in popularity there has been a concomitant increase in the frequency of all electric scooter-related injuries. The purpose of this study is to describe the most up-to-date trends in craniofacial fractures and lacerations related to electric scooter use among all age groups. We queried the National Electronic Injury Surveillance System (NEISS) for craniofacial fractures and lacerations related to e-scooters between 2010 and 2019. We then compared injury trends over time and between time periods before and after 2017 when electric scooter share apps revolutionized micromobility. We compared incidence of injury overall and by day of the week, patient demographics, and case severity based on clinical disposition. We identified an increase in the frequency of craniofacial lacerations and fractures in the 3 years following the introduction of electric scooter share services in 2017 (2017 and 2019), compared to the 3 years before this time (2014-2016). Young adults (18-39 years) were the age group with the greatest interval increase in craniofacial injuries. There was also an increase in number of craniofacial injuries occurring on Mondays and a decrease number occurring on Fridays in the later time period. Finally, patients who presented with electric scooter-related craniofacial injuries in this later time period showed a higher frequency of overnight observation and hospital admission for their injuries. The number of craniofacial injuries secondary to electric scooter use has increased dramatically since the introduction of share services. Craniofacial fractures and lacerations are a common reason for craniofacial or maxillofacial surgery consultation and understanding these patterns of injury will help prepare surgeons for patient care, preventative education, and public advocacy.

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Effect of educational intervention on the appropriate use of oral antimicrobials in oral and maxillofacial surgery: a retrospective secondary data analysis

BMC Oral Health ◽

10.1186/s12903-020-01367-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Junya Kusumoto ◽

Atsushi Uda ◽

Takeshi Kimura ◽

Shungo Furudoi ◽

Ryosuke Yoshii ◽

...

Keyword(s):

Educational Intervention ◽

Oral Surgery ◽

Maxillofacial Surgery ◽

Antibiotic Use ◽

Oral And Maxillofacial Surgery ◽

Third Generation ◽

Oral Antibiotics ◽

Appropriate Use ◽

Before And After ◽

Third Generation Cephalosporins

Abstract Background In Japan, oral third-generation cephalosporins with broad-spectrum activity are commonly prescribed in the practices of dentistry and oral surgery. However, there are few reports on the appropriate use of antibiotics in the field of oral surgery. This study aimed to evaluate the appropriateness of antibiotic use before and after an educational intervention in the Department of Oral and Maxillofacial Surgery, Kobe University Hospital. Methods The use of oral antibiotics was investigated among inpatients and outpatients before and after an educational intervention conducted by the antimicrobial stewardship team. Additionally, the frequency of surgical site infection after the surgical removal of an impacted third mandibular molar under general anesthesia and the prevalence of adverse effects of the prescribed antibiotics were comparatively evaluated between 2013 and 2018. Results After the educational intervention, a remarkable reduction was noted in the prescription of oral third-generation cephalosporins, but increased use of penicillins was noted among outpatients. There was reduced use of macrolides and quinolones in outpatients. Although a similar trend was seen for inpatients, the use of quinolones increased in this population. Despite the change in the pattern of antibiotic prescription, inpatients who underwent mandibular third molar extraction between 2013 and 2018 did not show a significant increase in the prevalence of surgical site infections (6.2% vs. 1.8%, p = .336) and adverse effects of drugs (2.1% vs. 0%, p = .466). Conclusions This study suggests that the judicious use of oral antibiotics is possible through conscious and habitual practice of appropriate antibiotic use. However, further investigation is required to develop measures for appropriate use of oral antibiotics.

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Effect of Point Defect Injection on B diffusion in C containing Si and SiGe

MRS Proceedings ◽

10.1557/proc-809-b8.6 ◽

2004 ◽

Vol 809 ◽

Author(s):

Mudith S. A. Karunaratne ◽

Janet M. Bonar ◽

Jing Zhang ◽

Arthur F. W. Willoughby

Keyword(s):

Computer Simulation ◽

Point Defect ◽

Mass Spectroscopy ◽

Diffusion Coefficients ◽

Secondary Ion Mass Spectroscopy ◽

Annealing Conditions ◽

Defect Injection ◽

Before And After ◽

Secondary Ion

ABSTRACTIn this paper, we compare B diffusion in epitaxial Si, Si with 0.1%C, SiGe with 11% Ge and SiGe:C with 11%Ge and 0.1%C at 1000°C under interstitial, vacancy and non-injection annealing conditions. Diffusion coefficients of B in each material were extracted by computer simulation, using secondary ion mass spectroscopy (SIMS) profiles obtained from samples before and after annealing.Interstitial injection enhances B diffusion considerably in all materials compared to inert annealing. In samples which experienced vacancy injection, B diffusion was suppressed. The results are consistent with the view that B diffusion in these materials occurs primarily via interstitialcy type defects.

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A multispectral 3D-Endoscope for Cholesteatoma Removal

Current Directions in Biomedical Engineering ◽

10.1515/cdbme-2020-3065 ◽

2020 ◽

Vol 6 (3) ◽

pp. 257-260

Author(s):

Eric L. Wisotzky ◽

Jean-Claude Rosenthal ◽

Anna Hilsmann ◽

Peter Eisert ◽

Florian C. Uecker

Keyword(s):

Multispectral Imaging ◽

Narrow Band ◽

Tissue Classification ◽

Step Size ◽

3D Endoscope ◽

Before And After ◽

Overlay Technique ◽

Ct Data ◽

Metric Dimensions ◽

20 Nm

AbstractWe present a stereo-multispectral endoscopic prototype using a filter-wheel to guide the removal of cholesteatoma tissue in the middle ear. An image-based method is used that combines multispectral tissue classification for the detection of tissue to be removed and 3Dreconstruction to determine its metric dimensions. The multispectral illumination used for tissue classification ranges from λ = 400 nm to λ = 500 nm with step-size of 20 nm, which results in six different narrow-band illumination modes. For classical RGB imaging and metric calculations, a broadband illumination mode is applied before and after the narrow-band illumination. The spectral information is augmented into the broadband mode using an overlay technique. The combination of multispectral imaging with stereoscopic 3D-reconstruction results in new valuable visualization of intraoperative data. This allows to generate a 3D-model of the patients anatomy highlighting the identified malicious tissue and compare the anatomical dimensions with pre-operative CT data.

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Salivary Pro-Inflammatory Markers and Smoking Status Influences the Treatment Effectiveness of Periodontal Disease Patients with Hypertension

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18147364 ◽

2021 ◽

Vol 18 (14) ◽

pp. 7364

Author(s):

Kun-Tsung Lee ◽

Zhu-Ling Guo ◽

Nai-Chia Teng ◽

Kuei-Ling Christine Hsu ◽

I-Hui Chen ◽

...

Keyword(s):

Periodontal Disease ◽

Recovery Rate ◽

Inflammatory Markers ◽

Treatment Effectiveness ◽

Smoking Status ◽

Periodontal Diseases ◽

Probing Depth ◽

Before And After ◽

Therapeutic Procedures ◽

History Of

Background: Hypertension and periodontal diseases share several risk factors. Inflammation biomarkers in saliva are related to hypertension and periodontal disease. The aim of this study was to explore the role of the salivary inflammatory biomarkers in the treatment effectiveness of patients with hypertension and periodontal disease. Methods: This observational study enrolled 160 subjects diagnosed with periodontitis, 40 of which had a history of hypertension. All subjects had completed scaling and root planning therapeutic procedures within four weeks. The clinical periodontal parameters (i.e., bleeding on probing, plaque control record (PCR), and probing depth (PD)) were evaluated before and after the treatment. Pro-inflammatory markers were determined using a commercial kit. Results: The recovery rate (PD 4–9 mm) in non-hypertensive subjects was significantly higher than in hypertensive subjects (60.47% vs. 52.60%, respectively; p = 0.04). All clinical parameters, excluding PCR, positively correlated with salivary IL-1β at baseline and after completing treatment. Our results showed that increased salivary IL-1β levels were positively associated with decreased PCR (β = −27.65 and p = 0.05) and PD recovery rate (β = −17.05 and p = 0.02) in hypertensive subjects. Conclusions: The present study sheds important light on the clinical use of salivary pro-inflammatory cytokines as valuable biomarkers for predicting the treatment effectiveness of patients suffering from hypertension and periodontitis.

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