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Oral and Maxillofacial Surgery Clinics... Nov 2012Orbital injuries are common and a common cause of blindness. The first priority for these injuries is the health of the globe. Imaging is imperative for diagnosing... (Review)
Review
Orbital injuries are common and a common cause of blindness. The first priority for these injuries is the health of the globe. Imaging is imperative for diagnosing orbital fractures, as clinical examination cannot thoroughly assess their presence or severity. When treatment is indicated, an anatomic reconstruction of the internal orbit is critical to the proper position and function of the ocular globe.
Topics: Diagnostic Imaging; Eye Injuries; Humans; Ophthalmologic Surgical Procedures; Orbital Fractures; Plastic Surgery Procedures
PubMed: 22981078
DOI: 10.1016/j.coms.2012.07.006 -
Revue Medicale Suisse Jul 2020Orbital fractures are frequent and can result in severe complications (visual impairment, diplopia and enophthalmos). Their management is challenging and remains... (Review)
Review
Orbital fractures are frequent and can result in severe complications (visual impairment, diplopia and enophthalmos). Their management is challenging and remains controversial. Whereas immediate surgery is clearly indicated in children with trapdoor fractures associated with annoying diplopia and observational management is indicated in cases with no diplopia, a grey zone of therapy decisions concern a significant portion of cases. Surgical repair is not trivial and can be plagued by severe complications such as visual impairment, globe misplacement and diplopia. Thus, the final decision should be based on a meticulous analysis of clinical and imaging findings and a wise assessment of the risks and benefits of either therapeutic alternative.
Topics: Diplopia; Enophthalmos; Humans; Orbital Fractures
PubMed: 32608584
DOI: No ID Found -
The Journal of Craniofacial Surgery Jun 2021The aim of the present study was to evaluate the injury patterns and etiology of orbital bone fractures treated at a busy level one trauma center.Between 2015 and 2019,...
The aim of the present study was to evaluate the injury patterns and etiology of orbital bone fractures treated at a busy level one trauma center.Between 2015 and 2019, patients with orbital bone fractures from the Department of Oral and Maxillofacial Surgery at the Royal London Hospital, were evaluated in a retrospective analysis. A pro-forma was used to collect data from electronic patient records. Parameters included age, gender, maxillofacial fracture, mechanism of injury, and length of hospital admission.Of 582 patients, 82% (n = 476) were male and 18% (n = 106) were female, with those in the age group 20 to 29 years most affected (36%; n = 212). The most common etiology was interpersonal violence (55%; n = 320), followed by falls (20%; n = 118) and road traffic accidents (12%, n = 68). The most common isolated orbital bone fracture site was the orbital floor (40%; n = 234). Of the impure orbital fractures, the zygoma was the most commonly involved structure adjacent to the orbit (19%, n = 110).In our department, the authors see high numbers of complex orbital bone requiring surgical treatment. Interpersonal violence is a significant cause of orbital bone fractures with young males most affected. This study provides an insight into the current trends in etiology, demographics, and clinical findings of orbital fractures that will help guide prevention and treatment strategies.
Topics: Accidental Falls; Accidents, Traffic; Adult; Female; Humans; London; Male; Orbital Fractures; Retrospective Studies; Trauma Centers; Young Adult; Zygoma
PubMed: 33405442
DOI: 10.1097/SCS.0000000000007384 -
Ophthalmic Plastic and Reconstructive... May 2001To describe the demographics, etiologic factors, clinical presentations, and outcomes of orbital fractures in children.
PURPOSE
To describe the demographics, etiologic factors, clinical presentations, and outcomes of orbital fractures in children.
METHODS
This was a retrospective case series of 96 consecutive patients under 18 years of age with orbital fractures presenting to the Massachusetts Eye and Ear Infirmary, including both hospitalized and nonhospitalized patients.
RESULTS
Orbital fractures in children were most frequently the result of sports, assault, or motor vehicle accident. The majority of patients did not require hospitalization and were treated as outpatients. The medial wall and floor of the orbit were the most frequent locations of fracture. Approximately half of the patients in this series required surgery, most often for entrapment. There were no cases of persistent diplopia in patients in whom surgery was performed or was not indicated. Associated ocular injuries were observed in half of the patients.
CONCLUSIONS
In this series of hospitalized and nonhospitalized patients, orbital fractures in children had a location pattern similar to that most frequently observed in adult patients (floor and medial wall). Orbital fractures in children frequently require surgery. The high prevalence of ocular injury in children with orbital fractures emphasizes the need for a comprehensive ophthalmic evaluation.
Topics: Adolescent; Age Distribution; Child; Child, Preschool; Eye Injuries; Female; Humans; Male; Massachusetts; Orbit; Orbital Fractures; Prevalence; Retrospective Studies; Sex Distribution
PubMed: 11388382
DOI: 10.1097/00002341-200105000-00005 -
Radiologie (Heidelberg, Germany) Mar 2024Orbital trauma can occur independently or in conjunction with other craniofacial trauma and can cause damage to bony and neurovascular structures as well as soft... (Review)
Review
Orbital trauma can occur independently or in conjunction with other craniofacial trauma and can cause damage to bony and neurovascular structures as well as soft tissues. Appropriate interdisciplinary treatment of patients is essential to prevent long-term damage such as blindness or muscle dysfunction. Even complex fractures and soft tissue damage can be visualized using modern thin-layer computed tomography (CT), which is necessary for proper treatment.
Topics: Humans; Orbital Fractures; Eye Injuries; Tomography, X-Ray Computed
PubMed: 38345620
DOI: 10.1007/s00117-024-01272-6 -
The Journal of Craniofacial SurgeryOrbital fractures account for up to 40% of craniofacial injuries. In this article, the authors present the transoral endoscopy-assisted plating technique for treating...
Orbital fractures account for up to 40% of craniofacial injuries. In this article, the authors present the transoral endoscopy-assisted plating technique for treating orbital blowout fractures (OBF). A retrospective analysis of 56 cases treated with transoral endoscopy-assisted approach was performed. Immediate versus delayed surgery decision-making was performed by using our 2-week algorithm. The surgical technique included only transoral incisions, forced duction and "pulse" tests, osteotomy, endoscopic inspections, the reduction with a curved elevator and an indwelling balloon, the retrieval of prolapsed fatty tissue back into the orbit, removal of sharp bony fragments, adaptation of the titanium mesh to the orbital floor and its fixation with screws to stable bony structures, reattachment of the osteotomized lateral wall, and postoperative computed tomography (CT) scan with 3D CT reconstruction. The overall success rate of surgeries was 96%. The resolution of comorbidities resulted in a normal globe position, normal eye movement, and the resolution of diplopia. Postoperative complications were insignificant with one case of surgical edema and one case of infection and sequestration that appeared six months after surgery. These results remained unchanged after 20 to 24 months of follow-up. The suggested minimally invasive transoral technique can be effectively implemented in cases of OBF as well as in cases when the medial wall of the orbit is involved. Our results presented a high success rate with minimal rate of complications, thus our technique is a safe way with minimal morbidity for treating OBF.
Topics: Dental Implants; Endoscopy; Fracture Fixation, Internal; Humans; Orbital Fractures; Retrospective Studies
PubMed: 34183635
DOI: 10.1097/SCS.0000000000007726 -
Frontiers of Medicine Sep 2013Minimally invasive surgical techniques, particularly endoscopic techniques, have revolutionized otolaryngeal surgery. Endoscopic techniques have been gradually applied... (Review)
Review
Minimally invasive surgical techniques, particularly endoscopic techniques, have revolutionized otolaryngeal surgery. Endoscopic techniques have been gradually applied in orbital surgery through the sinus inferomedial to the orbit and the orbital subperiosteal space. Endoscopic techniques help surgeons observe fractures and soft tissue of the posterior orbit to precisely place implants and protect vital structures through accurate, safe, and minimally invasive approaches. We reviewed the development of endoscopic techniques, the composition of endoscopic systems for orbital surgery, and the problems and developmental prospects of endoscopic techniques for simple orbital wall fracture repair.
Topics: Humans; Natural Orifice Endoscopic Surgery; Orbital Fractures; Otorhinolaryngologic Surgical Procedures; Radiography; Plastic Surgery Procedures; Treatment Outcome
PubMed: 23794028
DOI: 10.1007/s11684-013-0271-5 -
Ophthalmic Plastic and Reconstructive... Jul 2000
Comparative Study
Topics: Adolescent; Adult; Diagnosis, Differential; Humans; Orbital Fractures; Radiography; Trauma Severity Indices
PubMed: 10923982
DOI: 10.1097/00002341-200007000-00012 -
Ophthalmology Aug 2011To examine the type of orbital blowout fracture and its variation with race. (Comparative Study)
Comparative Study
PURPOSE
To examine the type of orbital blowout fracture and its variation with race.
DESIGN
Retrospective review of computed tomography (CT) scans and demography in an unselected cohort of patients with orbital blowout fractures.
PARTICIPANTS
Patients with a high-resolution CT scan of adequate quality for analysis who presented with an orbital blowout fracture to the Orbital Clinic at Moorfields Eye Hospital. Patients with fractures involving the orbital rim or the cranium, or with penetrating injuries of the globe or orbit, were omitted from the study.
METHODS
Demographic and ethnic information was collected for each patient, and the orbital scans were reviewed by a single observer. On the basis of coronal and axial imaging, a fracture was classified as affecting up to 4 areas: the floor lateral to the infraorbital canal (area 1, "A1"), the floor medial to the canal ("A2"), the maxillo-ethmoidal strut ("inferomedial" strut, "A3"), and the medial wall blowout fracture ("A4"); with fractures involving the inferomedial strut, it was noted whether there was displacement or rotation of the strut. Ethnic origin was classified as Caucasian, Afro-Caribbean, or Asian (Oriental or Indian).
MAIN OUTCOME MEASURES
The proportion of different walls involved in orbital blowout fractures within 3 ethnic groups.
RESULTS
A total of 152 patients (125 men, 82%) had imaging adequate for analysis; 103 (68%) were Caucasian, 19 (12%) were Afro-Caribbean, and 30 (20%) were Asian. Caucasians most commonly had floor fractures (A1 or A2 in 56 orbits, 54%) compared with 10 of 103 purely medial fractures (A4, 10%); in contrast, medial fractures were the most common type in Afro-Caribbean patients (7/19 cases, 37%), and purely floor fractures occurred in only 2 cases (10%) (P<0.005). Asian patients had results similar to those for Caucasian patients, with isolated floor fractures being the most common (14/30 cases, 47%).
CONCLUSIONS
Most blowout fractures involve the orbital floor in Caucasian and Asians, whereas in Afro-Caribbeans the most common site for fracture is the medial wall.
FINANCIAL DISCLOSURE(S)
The author(s) have no proprietary or commercial interest in any materials discussed in this article.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Asian People; Black People; Child; Ethnicity; Female; Humans; Male; Middle Aged; Orbital Fractures; Retrospective Studies; Risk Factors; Tomography, X-Ray Computed; White People; Young Adult
PubMed: 21684604
DOI: 10.1016/j.ophtha.2011.05.001 -
The British Journal of Oral &... Dec 2022Orbital fractures are among the most frequent facial traumas. This study retrospectively analysed patients treated in Umberto I Hospital Trauma-Centre, Sapienza...
Orbital fractures are among the most frequent facial traumas. This study retrospectively analysed patients treated in Umberto I Hospital Trauma-Centre, Sapienza University of Rome from 1 January 2010 to 31 December 2020. The inclusion criteria were as follows: diagnosis of pure/impure orbital bone fracture, complete clinical and radiological records, and a minimum 12-month follow up. Gender, age, aetiology, fracture type, treatment, and associated complications were analysed using IBM SPSS Statistics, and p values of <0.05 were considered significant. In total, 1393 patients presented with orbital trauma, 543 of whom met the inclusion criteria and underwent surgery (394 males (72.6%) and 149 females (27.4%); mean (range) age 39.2 (7-90) years). Assault (n = 165, 30.4%) was the most common cause of trauma, followed by road traffic accidents and sports-related incidents. Diplopia was the major symptom at diagnosis (n = 183, 33.6%). Open reduction and internal fixation via a sub-eyelid approach was the preferred treatment, achieving a significant reduction in the functional changes induced by fracture (p < 0.05). Our data will aid future studies of maxillofacial traumatology and suggest that education and prevention measures could reduce the incidence of this type of trauma.
Topics: Male; Female; Humans; Adult; Orbital Fractures; Retrospective Studies; Trauma Centers; Rome; Skull Fractures; Accidents, Traffic
PubMed: 36266195
DOI: 10.1016/j.bjoms.2022.09.003