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International Journal of Oral and... Aug 2024This report describes a rare case of complete transection of the inferior rectus resulting from blunt trauma to the orbit. Only eight other cases were identified in the...
This report describes a rare case of complete transection of the inferior rectus resulting from blunt trauma to the orbit. Only eight other cases were identified in the literature. Computed tomography scans should be examined carefully for potential extraocular muscle injury.
Topics: Humans; Wounds, Nonpenetrating; Oculomotor Muscles; Tomography, X-Ray Computed; Male; Eye Injuries; Orbit; Adult
PubMed: 37872056
DOI: 10.1016/j.ijom.2023.10.004 -
European Archives of... Jan 2024Due to the complexity of reconstructing wide inferomedial orbital wall fractures, silicone sheets are the preferred choice of reconstructive material. Nevertheless, it...
BACKGROUND
Due to the complexity of reconstructing wide inferomedial orbital wall fractures, silicone sheets are the preferred choice of reconstructive material. Nevertheless, it is crucial to remove the silicone sheet postoperatively due to the risk of delayed complications associated with its placement.
METHODS
We developed a procedure in which a silicone sheet implanted in the orbit can be extracted through the nasal cavity by removing the fractured portion of the medial orbital wall.
CONCLUSION
This procedure enables the utilization of silicone sheets, which are suitable for intricate orbital reconstruction, without any concerns regarding delayed complications.
Topics: Humans; Silicones; Orbit; Plastic Surgery Procedures; Nasal Cavity; Prostheses and Implants; Orbital Fractures
PubMed: 37831133
DOI: 10.1007/s00405-023-08257-6 -
BMJ Open Ophthalmology Oct 2023Functional outcomes following facial and ocular trauma are time-sensitive and require prompt evaluation to minimise long-term vision loss, yet few studies have...
OBJECTIVE
Functional outcomes following facial and ocular trauma are time-sensitive and require prompt evaluation to minimise long-term vision loss, yet few studies have systematically evaluated disparities in the management of these cases. This study investigates whether a patient's race/ethnicity, primary language, insurance status, gender or age affects receipt of ophthalmology consultation for facial trauma.
METHODS AND ANALYSIS
This study was a retrospective cohort analysis of patients from the Elmhurst City Hospital Trauma Registry in Queens, New York who were seen for facial trauma including open globe injuries and orbital fractures between January 2014 and May 2016.
RESULTS
Of the 264 patients included, 43% reported as Hispanic, 23% white, 11% Asian, 8% black and 15% other/unknown. After controlling for confounding variables by multivariable logistic regression, neither race/ethnicity, gender, nor primary language were significantly associated with the likelihood of receiving an ophthalmology consult. However, patients with private insurance had 2.57 times greater odds of receiving an ophthalmology consultation than those with Medicaid or state corrections insurance (95% CI 1.37 to 4.95). As age increased, the likelihood of receiving an ophthalmology consultation decreased (p=0.009); patients 60 years of age and older had one-third the odds of ophthalmology consultation as younger patients (OR 0.33; 95% CI 0.16 to 0.68).
CONCLUSIONS
This study highlights that lack of ophthalmology consultation in patients with facial trauma is linked to age and underinsurance. Extra attention must be paid during primary assessments to ensure elderly patients and those with public insurance have equitable access to timely and appropriate care for facial trauma.
Topics: United States; Humans; Aged; Ophthalmology; Retrospective Studies; Socioeconomic Disparities in Health; Ethnicity; Referral and Consultation
PubMed: 37797981
DOI: 10.1136/bmjophth-2023-001259 -
BMC Veterinary Research Sep 2023Subcutaneous emphysema and pneumomediastinum are rare complications associated with orbital blowout pathological fracture.
BACKGROUND
Subcutaneous emphysema and pneumomediastinum are rare complications associated with orbital blowout pathological fracture.
CASE PRESENTATION
A 7-year old, castrated male Abbysinian cat presented with anorexia, lethargy, nausea, eyelid swelling, nasal discharge, and sneezing. Based on the clinical and diagnostic work-up, the cat was diagnosed with T cell high-grade nasal lymphoma associated with orbital pathological fracture due to the tumour invasion. After chemotherapy, the cat showed massive subcutaneous emphysema from frontal region to abdomen and pneumomediastinum due to orbital blowout pathological fracture. As the nasal mass decreased in volume; the air had moved from the maxillary sinus to the subcutaneous region and the mediastinum through fascial planes in the head and neck region.
CONCLUSIONS
This is a first case report of a massive subcutaneous emphysema and pneumomediastinum due to an orbital blowout pathological fracture following chemotherapy in feline nasal lymphoma in veterinary medicine.
Topics: Male; Cats; Animals; Mediastinal Emphysema; Fractures, Spontaneous; Nose; Subcutaneous Emphysema; Lymphoma, T-Cell; Lymphoma, T-Cell, Peripheral; Cat Diseases
PubMed: 37715215
DOI: 10.1186/s12917-023-03722-0 -
Indian Journal of Plastic Surgery :... Aug 2023Orbital floor fractures are routinely encountered in facial trauma. Many factors influence the final outcome of the orbital floor surgery, time interval and the...
Orbital floor fractures are routinely encountered in facial trauma. Many factors influence the final outcome of the orbital floor surgery, time interval and the extent of other facial bone fractures are the two factors which can significantly influence the postoperative outcome following orbital floor reconstruction. Our study aims to find the ideal time for intervention and the association of other factors in the final outcome of orbital floor reconstruction. A retrospective and prospective cohort study of patients who were operated at Pondicherry Institute of Medical Sciences for orbital floor fractures, between 2011 January and 2017 July. All the data were entered on an Excel work sheet and statistically analyzed. In our study 8 patients (8/29, 27.58%) had diplopia prior to surgery, 5 patients (5/29, 17.24%) had complete recovery following surgery and 3 patients (3/29, 10.34%) had persistence of diplopia postoperatively. Patients with diplopia operated prior to 7 days were found to have significant improvement in postoperative diplopia. Patients with 5 or more facial fractures were found to have persistence of diplopia, infraorbital numbness, and enophthalmos postoperatively. Our study suggests that early intervention, before 7 days improves the outcome in patients with diplopia and provides a better result postoperatively. In our study preoperative diplopia and infraorbital numbness and postoperative persistence of enophthalmos, diplopia, and paresthesia were found more in patients with 5 or more facial bone fractures. Our study suggests a poor postoperative outcome when 5 or more facial bones are fractured.
PubMed: 37705826
DOI: 10.1055/s-0043-1769110 -
Journal of Cranio-maxillo-facial... Dec 2023The purpose of the present study was to investigate and compare craniomaxillofacial fracture (CMF) type in patients with intracranial hemorrhage (ICH) versus blunt...
Does the type of craniomaxillofacial fracture (CMF) differ between patients with intracranial hemorrhage (ICH) and those with blunt cerebrovascular injury (BCVI)? A retrospective study.
The purpose of the present study was to investigate and compare craniomaxillofacial fracture (CMF) type in patients with intracranial hemorrhage (ICH) versus blunt cerebrovascular injury (BCVI). A retrospective cohort study was performed. The predictor variables were the types of CMF. The primary outcomes variables were ICH and BCVI. Secondary outcomes were death and survival with or without neurological sequelae. Descriptive, bivariate, and multiple logistic regression statistics were computed, and the significance level was set at P ≤ 0.05. The sample was composed of 1440 patients with a mean age of 46.6 years ±24 years, and 71% were men. Pure orbital wall (odds ratio [OR]), 3.62; 95% confidence interval [CI], 1.32-12.69; P < 0.022), Le Fort III (OR, 16.08; 95% CI, 5.89-43.50; P < 0.001), cranial vault (OR, 9.74; 95% CI, 3.83.24.32; P < 0.001), skull base (OR, 9.42; 95% CI, 3.86-24.02; P < 0.001) and cervical fractures (OR, 5.50; 95% CI, 1.65-15.97; P = 0.003) were significantly associated with BCVI. All of the CMFs (P < 0.001), except for Le Fort I (OR, 0.79; 95% CI, 0.18-2.63; P = 0.731), nasal (OR, 1.05; 95% CI, 0.77-1.42; P = 0.758), and mandibular (OR, 0.68; 95% CI, 0.45-1.01; P = 0.066) fractures, were significantly associated with ICH. Secondary outcomes were negatively influenced by ICH and BCVI (P < 0.001). Within the limitations of the study it seems that Le Fort I and nasal fractures could be protective of cerebrovascular injuries, by cushioning impact forces. On the other hand it seems that patients with pure orbital wall, Le Fort III and cranio-cervical fractures are more prone to having concomitant life-threatening cerebrovascular injuries. This category of patients should have an immediate and comprehensive neurological assessment and CT angiography to rule out BCVI and to determine its severity.
Topics: Male; Humans; Middle Aged; Female; Retrospective Studies; Risk Factors; Cerebrovascular Trauma; Wounds, Nonpenetrating; Intracranial Hemorrhages; Spinal Fractures; Skull Base
PubMed: 37643933
DOI: 10.1016/j.jcms.2023.08.015 -
Journal of Clinical Medicine Aug 2023This systematic review summarizes recent literature on the use of extended reality, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), in... (Review)
Review
BACKGROUND
This systematic review summarizes recent literature on the use of extended reality, including augmented reality (AR), mixed reality (MR), and virtual reality (VR), in preoperative planning for orbital fractures.
METHODS
A systematic search was conducted in PubMed, Embase, Web of Science and Cochrane on 6 April 2023. The included studies compared extended reality with conventional planning techniques, focusing on computer-aided surgical simulation based on Computed Tomography data, patient-specific implants (PSIs), fracture reconstruction of the orbital complex, and the use of extended reality. Outcomes analyzed were technical accuracy, planning time, operative time, complications, total cost, and educational benefits.
RESULTS
A total of 6381 articles were identified. Four articles discussed the educational use of VR, while one clinical prospective study examined AR for assisting orbital fracture management.
CONCLUSION
AR was demonstrated to ameliorate the accuracy and precision of the incision and enable the better identification of deep anatomical tissues in real time. Consequently, intraoperative imaging enhancement helps to guide the orientation of the orbital reconstruction plate and better visualize the precise positioning and fixation of the PSI of the fractured orbital walls. However, the technical accuracy of 2-3 mm should be considered. VR-based educational tools provided better visualization and understanding of craniofacial trauma compared to conventional 2- or 3-dimensional images.
PubMed: 37629251
DOI: 10.3390/jcm12165203 -
Tomography (Ann Arbor, Mich.) Aug 2023Orbital floor fractures (OFFs) are common injuries of the midface and may result in long-term complications. The aim of this study was to compare two restoration...
Orbital floor fractures (OFFs) are common injuries of the midface and may result in long-term complications. The aim of this study was to compare two restoration materials, PDS foils and titanium meshes, with regards to (1) clinical outcome and (2) reduction in orbital volume. The monocentric discovery cohort was analyzed retrospectively and included 476 patients with OFFs treated between 2010 and 2020. A subcohort of 104 patients (study cohort) with isolated OFFs and available high-resolution imaging material was used for volume measurements. Postoperative complications were not significantly different between patients treated with different restoration materials. Prevalence of revision surgery was significantly higher in patients treated with thick PDS foils (25 mm). OFFs treated with PDS foils and titanium meshes showed a significant reduction in orbital volume ( = 0.0422 and = 0.0056, respectively), however, this volume decrease was significantly less pronounced in patients treated with PDS foils alone ( = 0.0134). Restoration using PDS foil in an isolated OFF reduces the orbital volume to a lesser extent than titanium mesh. Class III patients according to the classification of Jaquiéry with a missing bony ledge medial to the infraorbital fissure particularly benefit from restoration with PDS foils due to a lower reduction in the orbital volume. Regarding short- and long-term postoperative complications, a PDS foil thickness of 0.15 mm appears equivalent to titanium mesh in the treatment of OFFs.
Topics: Humans; Titanium; Retrospective Studies; Postoperative Complications
PubMed: 37624114
DOI: 10.3390/tomography9040121 -
Clinics and Practice Aug 2023Facial injuries caused by camels can be associated with adverse long-term effects on patients' quality of life. We aimed to investigate camel-related facial injuries in...
Facial injuries caused by camels can be associated with adverse long-term effects on patients' quality of life. We aimed to investigate camel-related facial injuries in Al-Ain City, UAE, focusing on their incidence, types, mechanisms, anatomical distribution, and outcomes, to enhance preventive measures. We retrospectively collected data from all patients who were admitted to our hospital with camel-related facial injuries from January 2014 through January 2021. Thirty-six patients were included; all were males, with a mean (range) age of 31 (14-66) years, 29 (80.5%) were camel caregivers. The most common mechanisms of injury were falling while riding a camel and camel kicks. The head was the most commonly injured region in 52.7%. Twenty-three (63.8%) patients had facial bone fractures. The middle third of the face accounted for 71.4% of the bony fractures. The most performed surgical procedures in our patients were soft tissue laceration repair and open reduction with internal fixation of fractures (ORIF). Camel-related facial injuries affect young adult male camel caregivers working on camel farms. Orbital and maxillary bone fractures are the most predominant fractures requiring operative management. Legislation for compulsory helmet usage may reduce the incidence of these injuries and their serious consequences.
PubMed: 37623262
DOI: 10.3390/clinpract13040081 -
The Journal of Craniofacial SurgeryA few mucoceles developing secondary to facial bone fractures have been reported. Mucocele formation is thought to be attributable to displacement of the respiratory...
A few mucoceles developing secondary to facial bone fractures have been reported. Mucocele formation is thought to be attributable to displacement of the respiratory mucosa with obstruction of the sinus opening, especially if untreated. Accurate diagnosis and management are required; a growing mucocele will gradually destroy adjacent bony structures and cause irreversible complications. The authors describe a patient who presented with diplopia and mild discomfort when gazing upward. She had undergone reconstruction of medial and inferior orbital fractures 20 years previously. The patient was diagnosed with a mucocele developing after orbital fracture repair. The patient underwent mucocele removal and orbital reconstruction using a polyetheretherketone patient-specific implant. In a patient with orbital symptoms but without acute trauma, a mucocele should be among the differential diagnoses if history-taking reveals past orbital trauma and surgery. A polyetheretherketone patient-specific implant was effective for orbital reconstruction after mucocele removal.
Topics: Female; Humans; Orbital Fractures; Mucocele; Tomography, X-Ray Computed; Dental Implants; Paranasal Sinus Diseases
PubMed: 37603895
DOI: 10.1097/SCS.0000000000009636