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Australian Journal of General Practice Jul 2022Ocular trauma may result in pathology of the ocular surface and adnexa, extraocular muscles, orbital walls, eye and optic nerve. Detailed history followed by a... (Review)
Review
BACKGROUND
Ocular trauma may result in pathology of the ocular surface and adnexa, extraocular muscles, orbital walls, eye and optic nerve. Detailed history followed by a complete ocular and, if indicated, radiological examination is therefore a crucial part of any trauma assessment. It is important to determine whether a patient with ocular trauma can be reassured or requires immediate referral for further investigation and surgical repair.
OBJECTIVE
This review examines chemical eye injuries, orbital fractures, superficial corneal foreign bodies, closed globe injury and suspected open globe injury with or without intra-ocular foreign bodies. A structured approach to the history and examination is provided. The aim of this article is to enhance clinician confidence when encountering these patients.
DISCUSSION
Ocular trauma can lead to serious sight‑ and eye-threatening consequences. Accurate history-taking and astute observation are paramount for timely treatment or referral that may prevent blindness. This review discusses the management and referral pathways for common presentations of ocular trauma.
Topics: Eye; Eye Injuries; Foreign Bodies; Humans
PubMed: 35773155
DOI: 10.31128/AJGP-03-21-5921 -
Seminars in Plastic Surgery Nov 2021Orbital fractures are common in facial trauma and can be a challenge to treat. Understanding anatomy of the orbit, the clinical evaluation, indications for surgery,... (Review)
Review
Orbital fractures are common in facial trauma and can be a challenge to treat. Understanding anatomy of the orbit, the clinical evaluation, indications for surgery, surgical approaches, complications, and postoperative are essential in providing appropriate treatment for patients who have sustained orbital fractures. In this article, the authors review the diagnostic evaluation, acute management, treatment options, and common complications of orbital fractures, as well as recent advancements in orbital fracture repairs.
PubMed: 34819809
DOI: 10.1055/s-0041-1735815 -
Tidsskrift For Den Norske Laegeforening... Apr 2022
Topics: Humans; Orbital Fractures; Tomography, X-Ray Computed
PubMed: 35383443
DOI: 10.4045/tidsskr.21.0586 -
Seminars in Plastic Surgery May 2019The orbit is contained within a complex bony architecture with overlying soft tissue that involves many important anatomical structures. Orbital trauma is a frequent... (Review)
Review
The orbit is contained within a complex bony architecture with overlying soft tissue that involves many important anatomical structures. Orbital trauma is a frequent cause of damage to these structures. The authors review the literature on reconstructive techniques focusing on fractures of the orbital rim, orbital roof, orbital floor, medial orbital wall, and naso-orbito-ethmoid complex. A thorough literature review was conducted using PubMed analyzing articles relevant to the subject matter. Various search terms were used to identify articles regarding orbital trauma presentation, diagnosis, management, as well as postoperative complications. Articles were examined by all authors and pertinent information was gleaned for the purpose of generating this review. Orbital trauma can result in a wide variety of complications in form and function. Not all orbital fractures require operative repair. However, bony disruption can cause enophthalmos, hypophthalmos, telecanthus, epiphora, cerebrospinal fluid leaks, orbital hematoma, and even blindness to name a few. Timing of operative repair as well as reconstructive method is dictated by the patient's individual presentation. Successful fracture management requires a detailed understanding of the anatomy and pathophysiology to ensure restoration of the patients' preoperative state. Orbital trauma encompasses a wide variety of mechanisms of injury and resulting fracture patterns. A variety of surgical approaches to the orbit exist as has been discussed allowing the surgeon access to all area of interest. Regardless of the fracture complexity, the principles of atraumatic technique, anatomic reduction, and stable fixation apply in all cases.
PubMed: 31037047
DOI: 10.1055/s-0039-1685477 -
Seminars in Plastic Surgery May 2017Facial fractures are a common source of emergency department consultations for the plastic surgeon. A working understanding of evaluation, assessment, management, and... (Review)
Review
Facial fractures are a common source of emergency department consultations for the plastic surgeon. A working understanding of evaluation, assessment, management, and prevention of further injury when dealing with these fractures is vital. This two-part series detailing the management of midface fractures serves as a guide for the appropriate workup and management of the wide variety of fracture patterns that are commonly encountered.
PubMed: 28496388
DOI: 10.1055/s-0037-1601372 -
Seminars in Plastic Surgery Feb 2017Orbital fractures are very common after facial trauma. The assessment of a patient with a suspected orbital wall injury includes a detailed oculofacial examination as... (Review)
Review
Orbital fractures are very common after facial trauma. The assessment of a patient with a suspected orbital wall injury includes a detailed oculofacial examination as well as radiologic imaging. Surgical repair with or without an implant may be indicated for diplopia, enophthalmos, or both. Cicatricial eyelid malposition is an iatrogenic complication commonly due to poor orbitotomy technique. Optimal repair involves direct exposure of the perimeter of the fractures' site through surgical planes that minimally scar the eyelids. A wide variety of implant options exist; however, thin, pliable, nonadherent materials such as nylon foil may offer several advantages. The authors describe the evaluation and management of orbital wall fractures.
PubMed: 28255287
DOI: 10.1055/s-0037-1598191 -
Archives of Craniofacial Surgery Sep 2016The medial wall and floor of the bony orbit are frequently fractured because of the delicate anatomy. To optimize functional and aesthetic results, reconstructive... (Review)
Review
The medial wall and floor of the bony orbit are frequently fractured because of the delicate anatomy. To optimize functional and aesthetic results, reconstructive surgeons should understand the anatomy and pathophysiology of orbital fractures. Appropriate treatment involves optimal timing of intervention, proper indications for operative repair, incision and dissection, release of herniated tissue, implant material and placement, and wound closure. The following review will discuss the management of orbital floor fractures, with the operative method preferred by the author. Special considerations in operation technique and the complication are also present in this article.
PubMed: 28913267
DOI: 10.7181/acfs.2016.17.3.111 -
Seminars in Plastic Surgery Nov 2020Zygomaticomaxillary (ZMC) fractures are the second most common facial fractures after nasal bone fractures. The zygoma, with its location and multiple points of... (Review)
Review
Zygomaticomaxillary (ZMC) fractures are the second most common facial fractures after nasal bone fractures. The zygoma, with its location and multiple points of articulations, lends itself to both facial structure and esthetics. Secondary ZMC deformities are complications of inadequate primary correction, delayed repair, or lack of repair. Secondary revisions of ZMC aim to correct ZMC displacement and projection and to address orbital discrepancies. Extensive correction involving significant orbital and malar defects requires zygomatic repositioning osteotomies and would greatly benefit from the utilization of virtual surgical planning, intraoperative navigation, and imaging. Minor corrections in malar projection can be corrected by onlay grafting and soft tissue augmentation and resuspension. Isolated or minor orbital corrections can be managed by autogenous or alloplastic material to restore lost orbital volume and anatomy.
PubMed: 33380910
DOI: 10.1055/s-0040-1721761 -
Seminars in Plastic Surgery Nov 2021Zygomaticomaxillary complex fracture is one of the most commonly treated facial fractures. Accurate reduction and stable fixation of the zygoma are required to restore... (Review)
Review
Zygomaticomaxillary complex fracture is one of the most commonly treated facial fractures. Accurate reduction and stable fixation of the zygoma are required to restore facial symmetry and projection and avoid functional sequalae from changes in orbital volume. Achieving optimal outcome is challenging due to the complex three-dimensional anatomy and limited visualization of all affected articulations of the zygoma. This article provides an updated overview of the evaluation and management of zygomaticomaxillary complex fractures based on available evidence and clinical experience at our center. The importance of soft tissue management is emphasized, and approaches to internal orbital reconstruction are discussed. While evidence remain limited, intraoperative imaging and navigation may prove to be useful adjuncts in the treatment of zygomaticomaxillary fractures.
PubMed: 34819807
DOI: 10.1055/s-0041-1735812