Cases reported "Diplopia"

Filter by keywords:



Filtering documents. Please wait...

1/17. Less common orbital fracture patterns: the role of computed tomography in the management of depression of the inferior oblique origin and lateral rectus involvement in blow-in fractures.

    During the past decade, advances in radiographic imaging have made it possible for the surgeon managing orbital fractures to adopt a rational therapeutic strategy based on a knowledge of alterations in surgical anatomy secondary to traumatic injury. To illustrate the value of computed tomography in the surgeon's armamentarium for management of orbital fractures, cases are presented in which imaging proved decisive in planning a course of therapy. Two patients presented with two types of isolated lateral blow-in fracture, an uncommon fracture pattern. The other cases underscore the value of defining involvement of the inferior oblique origin and lateral rectus muscles in imaging complex orbital fractures, issues not emphasized in earlier literature. Although diplopia alone does not always warrant surgical intervention, diplopia in the context of computed tomography-defined muscle entrapment or muscle origin displacement justifies operative therapy. These cases demonstrate the value of computed tomography in directing surgical therapy with resolution of diplopia and prevention and correction of enophthalmos.
- - - - - - - - - -
ranking = 1
keywords = enophthalmos
(Clic here for more details about this article)

2/17. Transient vertical diplopia and silent sinus disorder.

    A 57-year-old man had isolated transient recurrent vertical diplopia. Left hypoglobus and enophthalmos were present. Investigations revealed an otherwise asymptomatic left maxillary chronic aspecific sinusitis, with 8 mm lowering of the left orbital floor. Transient diplopia was thought to be secondary to transient fusion impairment. Orbital floor reconstruction cured the patient.
- - - - - - - - - -
ranking = 1
keywords = enophthalmos
(Clic here for more details about this article)

3/17. The spectrum of presentation of silent sinus syndrome.

    The general clinical, ophthalmologic, and radiologic features of three patients with silent sinus syndrome are presented. All three patients were treated surgically. The cases of these patients illustrate the spectrum of presentation of silent sinus syndrome, including enophthalmos, hypophthalmos, transient vertical diplopia, lid retraction, lagophthalmos, and blurred vision. All patients had sinus disease, and all patients improved after surgery using functional endoscopic sinus surgery techniques. The protean manifestations of silent sinus syndrome can be identified, thereby allowing appropriate management.
- - - - - - - - - -
ranking = 1
keywords = enophthalmos
(Clic here for more details about this article)

4/17. Conservative treatment of vertical diplopia in a patient with silent sinus syndrome.

    Silent sinus syndrome is a rare disease of the maxillary sinus characterized by bony absorption processes leading to progressive sinus wall thinning with consecutive enophthalmos and hypoglobus. It represents a benign cause of acquired enophthalmos and is often accompanied by painless vertical diplopia, the latter treated surgically in all cases published to date. We report a 56-year-old patient with silent sinus syndrome in whom vertical diplopia was treated with prisms showing that conservative treatment alone may, in mild cases, be an effective alternative to reconstructive surgery.
- - - - - - - - - -
ranking = 2
keywords = enophthalmos
(Clic here for more details about this article)

5/17. Delayed enophthalmos following a minimally displaced orbital floor fracture.

    We describe a case of an orbital floor fracture resulting in obstruction of the maxillary sinus ostium by herniated orbital contents. Our patient had delayed enophthalmos in a manner similar to silent sinus syndrome or imploding antrum syndrome. Obstruction of the maxillary sinus ostium by orbital contents carries the potential for delayed-onset enophthalmos and therefore suggests an additional indication for orbital floor fracture repair.
- - - - - - - - - -
ranking = 6
keywords = enophthalmos
(Clic here for more details about this article)

6/17. Evaluation of ocular changes secondary to blowout fractures.

    There has been extensive debate over the standard of care of orbital fractures. Entrapment, diplopia, and hypoglobus, with or without enophthalmos, are the most common clinical indications for surgical intervention. Evaluation of these injuries is often limited in the early postinjury period because of edema. In assessing the severity of the injury, the clinician often uses parameters such as changes in visual acuity, patient-reported diplopia, gross changes in globe position, and an evaluation of the extraocular muscles. Many of these parameters are only grossly assessed and therefore are not specifically documented and tracked. The decision to proceed with surgical intervention may be based only on these gross clinical findings. The purpose of this article is to present a reliable and repeatable method for evaluating the degree of diplopia and the globe position of the orbital trauma patient by describing the use of the double Maddox rod test (Wilson Ophthalmic, Mustang, OK) and Hertel exophthalmometer (Wilson Ophthalmic). These methods can provide sequential documentation of the progression of the injury and help better define the need for surgical intervention and to follow the postoperative course.
- - - - - - - - - -
ranking = 1
keywords = enophthalmos
(Clic here for more details about this article)

7/17. Endoscopic transmaxillary reduction and balloon technique for blowout fractures of the orbital floor.

    The indications for and timing of surgical treatment of blowout fractures of the orbital floor remain controversial. We report good results with the endoscopic transmaxillary reduction and balloon technique for blowout fractures of the orbital floor in the early stage after trauma in a consecutive series of 29 patients treated over the last 3 years, based on the following criteria: 1) diplopia observed by ophthalmological examination, 2) entrapment of intraorbital tissue at the fracture site on diagnostic imaging, mainly using CT scans, and 3) no improvement of diplopia during the acute phase (within one week of injury). Even in the presence of eyelid swelling, this method allows reduction and fixation of the fracture and impacted tissues simply and in a short time. Disappearance of diplopia was reported by 27 patients (93 %) within three months after surgery, and all 20 patients with enophthalmos were cured. There were only 4 cases with transient minor operative complications. Re-entrapment at the fracture site or relapse of symptoms was not seen during follow-up for 5 to 39 months (mean: 23.4 months). The combination of endoscopic transmaxillary reduction and the balloon technique for blowout fractures of the orbital floor is an effective and minimally invasive treatment with a high rate of improvement, not just for disturbances of ocular movement, but also for enophthalmos, which is often a problem in the long term.
- - - - - - - - - -
ranking = 2
keywords = enophthalmos
(Clic here for more details about this article)

8/17. Late enophthalmos mimicking silent sinus syndrome secondary to orbital trauma.

    The authors present a retrospective case report of a patient who experienced late enophthalmos after blunt orbital trauma. A 27-year-old man presented with subacute onset of enophthalmos, hypoglobus, superior sulcus deformity, and computed tomography evidence of a collapsed maxillary sinus 6 months after sustaining an ipsilateral moderately displaced orbital floor fracture. He was taken to surgery for left endoscopic maxillary antrostomy and implantation of an alloplastic orbital floor graft. Two months after surgery, the patient's diplopia, enophthalmos, hypoglobus, and superior sulcus deformity were markedly improved. Reestablishment of maxillary sinus aeration, the orbital floor, and the medial wall successfully relieved the symptoms and signs of maxillary wall implosion. The mechanism of this rare condition, which shares features similar to silent sinus syndrome, is presented.
- - - - - - - - - -
ranking = 7
keywords = enophthalmos
(Clic here for more details about this article)

9/17. Silent sinus syndrome: a case presentation and comprehensive review of all 84 reported cases.

    OBJECTIVES: The term silent sinus syndrome has been used to describe the constellation of progressive enophthalmos and hypoglobus due to gradual collapse of the orbital floor with opacification of the maxillary sinus, in the presence of subclinical chronic maxillary sinusitis. Currently, it is believed to occur as a result of the sequence of events following maxillary sinus hypoventilation due to the obstruction of the ostiomeatal complex. methods: In this study, we present a case of true silent sinus syndrome. In addition, we highlight the previously published cases of silent sinus syndrome, as well as provide a review of the etiology, pathophysiology, radiologic diagnosis, surgical treatment, and pitfalls to avoid in the management of patients with silent sinus syndrome. RESULTS: Eighty-three previously published cases of silent sinus syndrome were reported in the literature and are summarized in this review. CONCLUSIONS: A well-defined set of criteria is needed to classify a patient under the diagnosis of silent sinus syndrome, which include enophthalmos and/or hypoglobus in the absence of clinically evident sinonasal inflammatory disease.
- - - - - - - - - -
ranking = 2
keywords = enophthalmos
(Clic here for more details about this article)

10/17. Combined transcutaneous transethmoidal/transorbital approach for the treatment of medial orbital blowout fractures.

    BACKGROUND: The transcutaneous transorbital approach to medial orbital wall fractures facilitates placing a large implant or autogenous graft. However, its major disadvantage is the difficulty of accurately reducing the fractured medial orbital wall and herniated soft tissues with minimal morbidity. methods: To resolve this problem, a combined transcutaneous transethmoidal/transorbital approach through the same skin incision was developed at the Chonnam National University Medical School. Between 1997 and 2003, this approach was used in 54 patients with pure medial orbital blowout fractures. All fractures were larger than 2 cm in defect size and had 3 mm or more of bone displacement. RESULTS: Postoperative computed tomographic scans showed complete release of entrapped soft tissues and accurate reconstruction of bone defects in all cases. Complications related to the operation such as intraorbital and intramuscular hemorrhage, infection, and eyeball and optic nerve injuries were not observed, except in two cases with slight implant displacement. Follow-up ranged from 2 to 22 months, with an average of 9 months. Forty-one patients were evaluated 6 months or more after their reconstructive procedure. At the time of surgery, diplopia was present in 39 patients, eyeball movement limitation in 35 orbits, and enophthalmos of more than 2 mm in 16 orbits. Postoperatively, diplopia and eyeball movement limitation were resolved in most cases. Two patients had persistent diplopia for more than 1 year after surgery, and one of these needed extraocular muscle surgery. enophthalmos of more than 2 mm developed in three orbits, but enophthalmos of more than 3 mm was not observed in any orbit. Cosmetic results at the incision site were acceptable in all patients. CONCLUSIONS: The combined transcutaneous transethmoidal/transorbital approach is a safe procedure that can be performed with minimal morbidity; it offers the advantages of both the transcutaneous approach and the trans-nasal approach. Therefore, the authors suggest that this method be considered as a surgical alternative for the treatment of medial orbital blowout fractures, especially large and combined fractures of the medial wall and other parts of the orbit.
- - - - - - - - - -
ranking = 2
keywords = enophthalmos
(Clic here for more details about this article)
| Next ->


Leave a message about 'Diplopia'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.