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Otolaryngologic Clinics of North America Dec 2023Orbital floor fractures are a common manifestation of facial trauma that is encountered by ophthalmology, otolaryngology, and oral maxillofacial specialists. Surgical... (Review)
Review
Orbital floor fractures are a common manifestation of facial trauma that is encountered by ophthalmology, otolaryngology, and oral maxillofacial specialists. Surgical intervention is required emergently in cases of tissue entrapment and less urgently in cases of presenting with persistent diplopia, enophthalmos greater than 2 mm, and/or fractures involving greater than 50% of the orbital floor. Surgical management is a debated topic with differing opinions among surgeons regarding timing of repair, type of implant, and surgical approach.
Topics: Humans; Plastic Surgery Procedures; Orbital Fractures; Enophthalmos; Facial Bones; Prostheses and Implants; Retrospective Studies
PubMed: 37380516
DOI: 10.1016/j.otc.2023.05.002 -
Otolaryngologic Clinics of North America Dec 2023The pediatric patient population has unique anatomic characteristics that bring challenges and increased risk to management. The purpose of this article is to guide the... (Review)
Review
The pediatric patient population has unique anatomic characteristics that bring challenges and increased risk to management. The purpose of this article is to guide the head and neck trauma surgeon in decision making for the treatment of pediatric head and neck trauma with an emphasis on facial fracture management.
Topics: Humans; Child; Skull Fractures; Retrospective Studies
PubMed: 37460373
DOI: 10.1016/j.otc.2023.05.012 -
Ophthalmic Plastic and Reconstructive...The purpose of this study is to review the mechanisms in the development of orbital fractures. (Review)
Review
PURPOSE
The purpose of this study is to review the mechanisms in the development of orbital fractures.
METHODS
This is a comprehensive literature review that summarizes the mechanisms of developing orbital fractures.
RESULTS
There are 3 proposed mechanisms in the development of orbital fractures, which include the buckling, hydraulic, and globe-to-wall contact mechanisms. These mechanisms, as well as patient age, causes of injuries, and periorbital anatomy, influence the extent, sites, and patterns of orbital fractures.
CONCLUSION
A deeper understanding of these mechanisms helps us to detect and properly manage orbital fractures in the clinical setting.
Topics: Humans; Orbital Fractures; Eye Injuries; Eye; Face
PubMed: 37450646
DOI: 10.1097/IOP.0000000000002426 -
Oral and Maxillofacial Surgery Clinics... Aug 2023Maxillofacial trauma is common. Computed tomography is the primary imaging tool for diagnosis. Study interpretation is aided by understanding regional anatomy and... (Review)
Review
Maxillofacial trauma is common. Computed tomography is the primary imaging tool for diagnosis. Study interpretation is aided by understanding regional anatomy and clinically relevant features of each subunit. Common injury patterns and the most important factors related to surgical management are discussed.
Topics: Humans; Maxillofacial Injuries; Tomography, X-Ray Computed; Skull Fractures; Orbital Fractures
PubMed: 37032179
DOI: 10.1016/j.coms.2023.02.001 -
Cureus Jan 2024Transorbital penetrating brain injuries (TOPI) are rare. We report a case of industrial injury that resulted in perforating eye injury and intracranial foreign body by a...
Transorbital penetrating brain injuries (TOPI) are rare. We report a case of industrial injury that resulted in perforating eye injury and intracranial foreign body by a nail gun. A 30-year-old man accidentally fired a nail gun onto his left eye at his construction workplace while handling the malfunctioned equipment and sustained a perforating injury of the left eye with intracranial foreign body. The misfired nail was lodged in his frontal lobe of the brain. He also suffered laceration wounds of the lateral canthus of the left eye and fractures of the left orbital floor and roof. He underwent emergency bicoronal craniotomy and removal of intracranial foreign body, followed by left eye examination under anaesthesia as well as scleral toilet and suturing. The nail was successfully removed. He recovered well with no neurological deficit and was discharged on postoperative day 5 with a Glasgow Coma Scale score of 15; however, his left eye vision remained no perception of light. Work-related eye injuries can be debilitating and are largely preventable.
PubMed: 38333444
DOI: 10.7759/cureus.51974 -
The Journal of Craniofacial SurgeryPreoperative computer-assisted planning and intraoperative navigation are becoming popular for orbital fracture treatment. However, not all institutions currently have...
Preoperative computer-assisted planning and intraoperative navigation are becoming popular for orbital fracture treatment. However, not all institutions currently have access to these computer-aided applications. The authors present a simple and intuitive operative algorithm to guide orbital fracture reconstructions. The operative algorithm was based on linear measurements of orbital defects on high-resolution Computer tomography (CT) scans using specific axial, coronal, and sagittal plane images. The fractures were then divided into 3 types based on site and defect-size area. For each type, the authors suggested a surgical approach and material reconstruction. Between February 2022 and January 2023, 57 patients were treated according to the described CT-based protocol. The quality of reconstruction was classified as ideal, satisfactory, acceptable, and poor based on postoperative CT. Diplopia, enophthalmos, and postoperative complications were assessed. Fifty-seven patients were included. Forty-four (77.2%) patients were included in the type 1 group, 4 (7.01%) in the type 2 group, and 9 (15.79%) in the type 3 group. The reconstruction was considered ideal in 54 (94.7%) cases, satisfactory in 2 (3.5%), and acceptable in 1 (1.8%). No revision surgery was required. In all cases, preoperative diplopia was settled out, and only 1 patient reported postoperative enophthalmos. No complications occurred, with good clinical results and orbital symmetry. The linear CT measurement-based protocol is a simple and reliable workflow to guide the surgeon's choice of reconstruction material and surgical approach for primary orbital reconstruction. It allows good management of orbital trauma and could help standardize treatment decisions with an imaging technique available in all institutions.
Topics: Humans; Enophthalmos; Orbital Fractures; Diplopia; Tomography, X-Ray Computed; Computers; Orbit; Retrospective Studies; Treatment Outcome
PubMed: 38011262
DOI: 10.1097/SCS.0000000000009668