1/146. Reduction of nasal orbital fractures and simultaneous dacryocystorhinostomy.A technique for restoration of structure and function in naso-orbital fractures has been described. Three case reports demonstrate a few of the final results. The case reports also indicate that many of these fractures require late definitive surgery in spite of optimal surgical treatment immediately subsequent to injury.- - - - - - - - - - ranking = 1keywords = orbital (Clic here for more details about this article) |
2/146. Traumatic displacement of the globe into the ethmoid sinus.PURPOSE: To describe displacement of the globe into the ethmoid sinus after an orbital trauma. METHOD: Case report. A 58-year-old man sustained trauma of the left eye and orbit, which resulted in displacement of the globe into the ethmoid sinus. One day after injury, surgery was performed to restore the intact globe into position within the orbit. RESULTS: After operation, the globe held in its anatomical site, and 10 months after surgery the visual acuity was 20/100, slight pallor of the optic disk was present, and there was no limitation of the horizontal and vertical ductions. CONCLUSIONS: To our knowledge, this is the first case of traumatic displacement of the globe into the ethmoid sinus with satisfactory restoration of normal globe position and preservation of vision.- - - - - - - - - - ranking = 0.2keywords = orbital (Clic here for more details about this article) |
3/146. Reconstruction of the orbital roof by acrylic prosthesis.Presentation of two cases of open orbital roof fracture with destruction of all the orbital roof extending from the fronto-maxillo region to the spina orbitalis. After a first emergency neurosurgical treatment, a cast of the excised soiled bone fragment was taken and identical replica was made from methylmethacrylate. In a second surgical procedure, the resine mould was set in place by endocranicl approach, and was fastened firmly to the surrounding bone with wire sutures. In such types of defects cranioplasty and orbitoplasty are mandatory.- - - - - - - - - - ranking = 1.4keywords = orbital (Clic here for more details about this article) |
4/146. Treatment of enophthalmic narrow palpebral fissure after blow-out fracture.Surgery for a narrow palpebral fissure caused by enophthalmos after a blow-out orbital fracture was performed in three patients from seven months to three years after injury. The surgery was directed not to the cause of the enophthalmos, but to the narrowed palpebral fissure which was the noticeable cosmetic defect. The surgical procedure used to widen the palpebral fissure was the Muller's muscle-conjunctival resection blepharoptosis operation, and a phenylephrine test was used preoperatively to select candidates for this operation. After widening of the palpebral fissure, which created the illusion of exophthalmos, the cosmetic result was acceptable.- - - - - - - - - - ranking = 0.2keywords = orbital (Clic here for more details about this article) |
5/146. The use of the Naugle orbitometer in maxillofacial trauma.BACKGROUND AND OBJECTIVES: Objective measuring of globe position is not a universal practice in the management of orbital trauma. Few studies in the literature advocate its routine use. methods AND MATERIALS: The Hertel exophthalmometer is the most widely used instrument; however, in trauma involving the lateral orbital rim (e.g., in zygoma fractures), the results are inaccurate because the displacement of the zygomatic bone interferes with its reference point on the lateral orbital rim. A more recent measuring device, the Naugle orbitometer, was introduced in 1992. It uses the superior orbital rim (frontal bar) and inferior orbital rim (malar eminence) as reference points. RESULTS AND/OR CONCLUSIONS: This article reports experience with this instrument in objective measuring the position of the globe in orbital trauma. These measurements are used 1) to monitor fractures that may not require repair but should be followed and observed for dystopia or enophthalmos, 2) to determine the adequacy of fracture repair, and 3) to determine the volume adjustment required for correcting enophthalmos. Future studies will be directed to compare the accuracy of Naugle and Hertel exophthalmometers.- - - - - - - - - - ranking = 1.2keywords = orbital (Clic here for more details about this article) |
6/146. Nasoethmoid orbital fractures: diagnosis and management.BACKGROUND AND OBJECTIVES: Trauma to the central midface may result in complex nasoethmoid orbital fractures. Due to the intricate anatomy of the region, these challenging fractures may often be misdiagnosed or inadequately treated. The purpose of this article is to aid in determining the appropriate exposure and method of fixation. methods AND MATERIALS: This article presents an organized approach to the management of nasoethmoid orbital fractures that emphasizes early diagnosis and identifies the extent and type of fracture pattern. It reviews the anatomy and diagnostic procedures and presents a classification system. The diagnosis of a nasoethmoid orbital fracture is confirmed by physical examination and CT scans. Fractures without any movement on examination or displacement of the NOE complex on the CT scan do not require surgical repair. Four clinical cases serve to illustrate the surgical management of nasoethmoid fractures. RESULTS AND/OR CONCLUSIONS: Early treatment using aggressive techniques of craniofacial surgery, including reduction of the soft tissue in the medial canthal area and restoration of normal nasal contour, will optimize results and minimize the late post-traumatic deformity. A high index of suspicion in all patients with midfacial trauma avoids delays in diagnosis.- - - - - - - - - - ranking = 1.4keywords = orbital (Clic here for more details about this article) |
7/146. Orbital deformity after craniofacial fracture repair: avoidance and treatment.BACKGROUND AND OBJECTIVES: To achieve the optimal preoperative appearance following craniofacial fracture repair, the surgeon must be facile in the most sophisticated reconstructive techniques and able to determine their application. The purpose of this article is to describe the common deformities following such repairs, outline a strategy to avoid them, and review the surgical techniques to correct them. methods AND MATERIALS: The deformities are categorized by the anatomic zones of the orbit, i.e., zygomatic, frontal, and nasoethmoidal, affected by low-, middle-, and high-energy impact. The common types of deformity and acute and late treatments are discussed for each category. RESULTS AND/OR CONCLUSIONS: The optimal time to correct posttraumatic orbital deformities is during the acute phase. Extended open reduction and rigid fixation techniques have their own morbidity, which must not outweigh the deformity of an untreated or partially treated injury. The results of late reconstruction are always limited by scarring of the overlaying soft tissue envelope.- - - - - - - - - - ranking = 0.2keywords = orbital (Clic here for more details about this article) |
8/146. An algorithm for management of residual posttraumatic calvarial defects in adults.For the discussion of options in late reconstruction of residual posttraumatic calvarial defects in adults, the calvaria is divided into three reconstructive zones. Zone 1 comprises the frontal sinus region and the contour of the supraorbital brow; Zone 2 comprises the smooth, cosmetically visible prehairline forehead; Zone 3 comprises the posthairline area and the calvaria. The particular reconstructive requirements (autogenous bone versus alloplastic material) of each zone are described and illustrated with clinical cases. The merits of bone from various donor sites and those of alloplastic material are discussed. The authors present an algorithm of reconstructive choices for residual posttraumatic calvarial defects in adults based on the nature of the defect and the aesthetic reconstructive zone.- - - - - - - - - - ranking = 0.2keywords = orbital (Clic here for more details about this article) |
9/146. Management of orbital-sinus foreign bodies.Orbital-sinus foreign bodies traverse the orbit and lay, at least partially, within the paranasal sinuses. Most of these injuries occur as a result of facial trauma. In most cases, history alone is not sufficient to rule out a retained foreign body. Early magnetic resonance imaging is necessary to evaluate the full extent of injury. Since these foreign bodies may cause a severe orbital infection and threaten the patient's vision, surgical removal is recommended. Endoscopic sinus surgery provides a safe and effective approach for extraction of these foreign bodies that can be used alone or in conjunction with other surgical approaches. The case of an orbital-sinus foreign body is presented together with a comprehensive approach for diagnosis and management of this type of injury.- - - - - - - - - - ranking = 1.2keywords = orbital (Clic here for more details about this article) |
10/146. Frontobasilar blast injuries: access and treatment.blast injuries involving the frontobasilar region and orbit can present difficult evaluation and treatment challenges. This article presents the surgical treatment of four patients presenting with blast-type injuries involving the central periorbital region and anterior skull base. Three of these were the result of close-range gunshot wounds, and one was caused by an avulsive penetrating tree branch injury during a motor vehicle accident. All four patients underwent frontal craniotomy for exposure to repair significant intracranial injuries. Following intracranial repair of dural and brain injuries, anterior cranial fossa reconstruction was performed. In two of these patients, elective supraorbital osteotomies were performed to allow improved access to the posterior aspect of the anterior skull base. The healing period of all four patients has been without complications relative to the anterior fossa injuries.- - - - - - - - - - ranking = 0.4keywords = orbital (Clic here for more details about this article) |
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