Cases reported "Orbital Fractures"

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1/64. Benefits of stereolithography in orbital reconstruction.

    OBJECTIVE: To describe the benefits of the stereolithography (SLA) modeling system in the evaluation and surgical planning of selected bony orbital pathology. DESIGN: Two case reports. PARTICIPANTS: One patient presented with a displaced left orbital roof fracture into his orbit causing globe compression and binocular vertical diplopia. A second patient underwent removal of his right orbital floor, medial wall, and inferior portion of his lateral wall during excision of a cylindrical cell papilloma of the paranasal sinuses. Postoperatively, he suffered from globe ptosis and binocular oblique diplopia. INTERVENTION: Stereolithographic models of the patients' orbits were obtained from computed tomography data to better assess the bony orbital pathology. In the second patient, the model was used as a template to create a temporary custom fit prosthesis to repair the defect of his orbital walls. RESULTS: The SLA models were useful in evaluating the dimensions of the bony defects and in preoperative surgical planning. Intraoperatively, the SLA models facilitated orbital surgical rehabilitation. Postoperatively, both patients noted resolution of their diplopia after reconstruction of more normal bony anatomy. CONCLUSIONS: In selected cases, SLA offers highly accurate models of the bony orbit for preoperative evaluation, surgical planning, and teaching and can act as a template for custom prosthesis manufacturing. This technology increases the orbital surgeon's options in managing complex orbital pathology.
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ranking = 1
keywords = nasal
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2/64. Missed orbital wall blow-out fracture as a cause of post-enucleation socket syndrome.

    BACKGROUND: Post-enucleation socket syndrome (PESS: deep upper lid sulcus, ptosis or upper lid retraction, enophthalmos and lower lid laxity) is a well-recognised complication of a volume-deficient anophthalmic socket. A patient requiring enucleation following severe ocular trauma may have an underlying orbital wall blow-out fracture which if overlooked can cause severe volume deficit with poor cosmesis and limited prosthesis motility. PURPOSE: To establish the prevalence of an undiagnosed blow-out fracture in patients with PESS and a history of relevant trauma. methods: medical records and orbital computed tomography (CT) scans were reviewed for all patients presenting with PESS and a history of relevant trauma. RESULTS: Undiagnosed blow-out fractures were found in 15 (33%) of 45 patients presenting between August 1993 and December 1996. These were significant enough to warrant surgical repair in 13 (29%) patients. CONCLUSIONS: We suggest that any patient presenting with PESS and a history of relevant trauma should be considered to have an orbital wall blow-out fracture until proven otherwise by CT scanning of the orbit. Similarly any patient requiring enucleation following severe ocular trauma should undergo CT scanning to rule out a coexisting blow-out fracture which could be repaired at the time of enucleation.
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ranking = 4.5329168540246
keywords = nose
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3/64. Sino-orbital fistula: two case reports.

    A fistula between the paranasal sinuses and the orbit as a late complication of orbital fractures is rare and may present with intermittent symptoms due to air passing into the orbit. A case note review of two patients with sino-orbital fistula is presented. Two patients, 23- and 30-year-old males, presented with intermittent symptoms of globe displacement, diplopia or discomfort months after repair of an orbital floor fracture with a synthetic orbital floor implant. The symptoms occurred after nose blowing. They were both cured by removal of the implant and partial removal of the tissue surrounding the implant. A sino-orbital fistula may complicate the otherwise routine repair of an orbital floor fracture, but may be cured by removal of the implant and part of the surrounding pseudocapsule.
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ranking = 3.2664584270123
keywords = nose, nasal
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4/64. Intranasal endoscopy-assisted repair of medial orbital wall fractures.

    The repair of medial orbital blow-out fractures remains a challenging surgical procedure for most surgeons. Endoscopic intranasal visualization of the medial orbital wall or lamina papyracea is a technique familiar to most otolaryngologists. This endoscopic view would allow for confirmation of orbital content reduction and bimanual manipulation of an orbital implant. To determine the effectiveness of a new surgical technique, a cadaveric study was performed to evaluate the ability to (1) reduce the herniated orbital contents and (2) restore the normal anatomic orbital configuration and volume with the addition of an orbital implant. Excellent visualization of the fracture was achieved in all cadaveric specimens. In addition, endoscopic intranasal visualization of the medial orbital wall greatly facilitated the anatomic reduction of orbital contents and proper placement of the orbital implant. The surgical technique is described and a clinical case is reported in which this endoscopic technique was effectively used. Arch Facial Plast Surg. 2000;2:269-273
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ranking = 6
keywords = nasal
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5/64. Barotraumatic blowout fracture of the orbit.

    We report a rare case of a barotraumatic blowout fracture of the orbit. A 32-year-old woman presented with sudden swelling of the right orbital region after vigorous nose blowing. Computed tomography scan revealed a blowout fracture of the medial wall of the right orbit with orbital emphysema and herniation of the orbital soft tissue. She was treated with prednisolone and an antibiotic, and did not show diplopia or visual disturbance. Three different theories have so far been proposed to explain the mechanism of blowout fractures, globe-to-wall contact theory, hydraulic theory, and bone conduction theory. The present case indicates that blowout fractures of the orbit can be induced solely by a sudden change of pressure, thereby suggesting the validity of the hydraulic theory.
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ranking = 2.2664584270123
keywords = nose
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6/64. Ophthalmic complications after surgery for nasal and sinus polyposis.

    PURPOSE: To describe ophthalmic complications after nasal and sinus surgery. methods: Four cases with orbital complications were retrospectively selected from among more than 2000 cases of orbital pathologies. RESULTS: Motility disturbances due to extraocular muscle injury occurred in two patients after intranasal ethmoidectomy and in one patient after a Caldwell-Luc procedure. In the fourth case an orbital apex syndrome was noted after intranasal ethmoidectomies. CONCLUSIONS: Ophthalmic complications may occur after nasal and sinus surgery, even using an endoscopic procedure. Successful handling of these complications could be reached by on their early recognition and treatment.
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ranking = 8
keywords = nasal
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7/64. A case of traumatic globe luxation.

    We observed a case of traumatic globe luxation. A 26-year-old man who was sitting at the back seat of the car without fastening his safety belt was admitted to the emergency room after an automobile accident. He was in semi-comatose condition. His left globe was dislocated anteriorly, and the lids were tightly closed behind it. No laceration was observed in cornea, sclera and extraocular muscles. The pupil was dilated and did not respond to light stimulation. Computerized tomography scan analysis revealed a normal optic nerve, but multiple fractures in the nasal, inferior and temporal walls of the orbit and in the nasal bone. Phthisis of the eye was detected by the end of second month. We believe that the back seats of automobiles should also be furnished with air bags for better security of passengers.
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ranking = 2
keywords = nasal
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8/64. 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.
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ranking = 3.2664584270123
keywords = nose, nasal
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9/64. Brown's syndrome diagnosed following repair of an orbital roof fracture: a case report.

    The upgaze deficit of Brown's syndrome differs from the upgaze deficit of an orbital floor fracture with entrapment. In Brown's syndrome, the upgaze limitation is most evident in adduction of the eye. This difference may be difficult to establish at times, particularly beneath the periorbital edema of an acute traumatic injury. Nevertheless, it is important to recognize this differentiation, since the approach to management of these two clinical entities is distinctly dissimilar. Brown's syndrome is produced by restriction of the superior oblique muscle tendon, usually in the region of the trochlea. In the course of describing a case of Brown's syndrome, recognized following the repair of an orbital roof fracture, issues related to etiology, diagnosis, and management are discussed. In the case presented, surgical repair of the left eye was performed.
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ranking = 9.0658337080492
keywords = nose
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10/64. 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.
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ranking = 1
keywords = nasal
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