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Results for “Orbital fractures”

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At least 19 recordsLinked to original sources
PubMed1992

Severe orbital infection as a complication of orbital fracture.

Orbital fractures secondary to blunt trauma, and their complications, have been the subject of numerous reports, with little mention of an association with severe orbital infection. Conversely, studies of severe (postseptal) orbital infections rarely make reference to orbital fractures as being a significant pathogenetic factor. In a retrospective study of 130 orbital infections, three cases of severe orbital infection were identified as being associated with an orbital fracture, and are thus presented. In the literature, only anecdotal reports and inconclusive studies address this problem, and its possible prevention. The consequences of a pathologic communication between the paranasal sinuses and the orbit secondary to blunt facial trauma are discussed, along with recommendations for prophylactic management.

Adult↗
PubMed1987

Orbital cellulitis and orbital fractures.

Orbital cellulitis as a complication of orbital fracture is discussed. Three cases of orbital cellulitis that followed trauma to the orbit are presented. A description of the proposed mechanism by which an orbital fracture predisposes to cellulitis follows. Suggestions are made for prophylactic management.

Adult↗
PubMed1989

[Computed tomography in the evaluation of orbital fractures].

Orbital fractures should be evaluated by CT in frontal and transverse planes. The significance of blow-out floor and medial wall fractures is discussed. Limitation of inferior rectus muscle mobility is thought to be a result of edema, enophthalmos, fat prolapse or scar tissue formation, rather than muscle incarceration. The consequent therapeutic attitude implies a rigorous preoperative exploration by CT or for some orbital floor fractures by MR.

Adult↗
PubMed2000

Reconstruction of orbital fractures with dehydrated human dura mater.

PURPOSE: The best method for reconstructing the fractured orbital floor remains controversial. This article evaluates the usefulness of dehydrated human dura mater for orbital floor reconstruction after facial trauma. PATIENTS AND METHODS: A retrospective analysis of 55 patients who had undergone surgical repair of orbital fractures was performed. The dura mater was used when the disruption was less than 2 cm in diameter. Fractures were divided into 3 types: type I (blow-out), type II (orbitozygomatic fracture), and type III (midfacial fracture). The patients were followed-up at least 1 year after surgery, and the cosmetic and functional results were reviewed. RESULTS: A 7% complication rate was noted. No implant migration or infection resulted. One year postsurgery, all patients showed a complete resolution of their diplopia. CONCLUSION: The safety and biocompatibility of dehydrated human dura mater support its use in orbital defects less than 2 cm in diameter.

Accidental Falls↗
PubMed2002

Ocular and periocular injuries from orbital fractures.

BACKGROUND: Orbital fractures are associated with ocular and periocular injuries. The role of the ophthalmologist in the evaluation and management of facial trauma, including orbital fractures, has not been clearly defined. The purpose of this study is to identify and characterize ocular and periocular injuries associated with orbital fractures to define the role of the ophthalmologist in the management of facial trauma. STUDY DESIGN: Retrospective case review. RESULTS: Three hundred sixty-five patients with orbital fractures who were evaluated by an ophthalmologist as part of their initial trauma evaluation were studied. The majority of the patients with orbital fractures (74%) did not have associated ocular or periocular injuries. Twenty-three of 104 (22%) ocular injuries in 23 of 95 (24%) patients required immediate intervention by an ophthalmologist. CONCLUSIONS: Facial trauma and orbital fractures are associated with significant ocular and periocular injuries, the minority of which require immediate evaluation and treatment by an ophthalmologist. These results differ from those previously reported.

Eye Injuries↗
PubMed2006

Endoscopic orbital fracture repair.

Orbital fractures involving the middle or posterior third of the orbital floor are difficult to visualize with traditional surgical approaches. The authors describe their method of combining a transconjunctival incision with an endonasal endoscopic approach in the repair of orbital fractures. In their experience, this technique is especially useful in the treatment of posterior fractures or secondary repairs for residual enophthalmos. Besides better visualization, advantages include increased illumination; video projection for the rest of the surgical team and for documentation and recording; confirmation of correct implant placement; and, most importantly, precise and complete reduction of herniated orbital soft tissues.

Endoscopy↗
PubMed1996

[Orbitography in orbital fractures].

The authors present four cases of fractured orbit where the radiological examination with contrast orbitography was applied using the new Multiscop apparatus with digitized picture from Siemens. The examination was found to be very helpful for proper and detailed diagnosis and for choosing the appropriate operational method.

Female↗
PubMed1990

Early repair of complex orbital fractures.

Complex orbital fractures consist of fractures of the orbital rim and walls in two or more places and may be associated with more extensive facial fractures. Previously, delayed repair was the standard approach. Techniques of craniofacial surgery allow earlier reconstruction with more accuracy and stability. Enophthalmus, dystopia and facial contour deformities are avoided, and the final result improved. A new standard has been established. Three factors are important in attaining improved results. Three-dimensional CT scanning is used to obtain a comprehensive assessment of the injury, to plan reconstruction pre-operatively, and to assess the reconstruction post-operatively. Secondly, complete exposure of the facial skeleton is necessary and is achieved by the use of a coronal incision, frontal flap, infraorbital incision, and intraoral upper sulcus incision. Thirdly, cranial bone grafting is used to reconstruct orbital floors and severely comminuted or missing bones. Finally, the use of mini-plates and lag screws provides improved accuracy and stability of the reconstruction.

Bone Screws↗
PubMed1987

Absorbable gelatin film verses silicone rubber sheeting in orbital fracture treatment.

Orbital floor fractures can result in herniation of orbital tissues and impairment of ocular function. In this experimental study, orbital defects were created surgically in cats. The gross and histologic healing of these defects was compared among animals implanted with silicone rubber sheeting or absorbable gelatin film and animals that received no implants. Both implanted animal groups demonstrated enhancement of healing. The absorbable gelatin film showed less migration, less inflammatory response, and improved healing. This animal study supports the use of absorbable gelatin film in the surgical management of orbital fractures.

Absorption↗
PubMed1999

Surgical treatment for greater sphenoid wing fracture (orbital blow-in fracture).

The authors present 2 patients with greater sphenoid wing fractures that were treated surgically. This type of fracture is classified as a blow-in fracture of the lateral orbital wall. The first patient was a 16-year-old boy who was involved in a motor vehicle accident. Computed tomography (CT) disclosed a medial displacement of the inner wall of the greater sphenoid wing of the left orbit. He was unconscious for 3 days. After he recovered consciousness, he presented limited abduction of the left eye with diplopia in all gaze directions and mild left proptosis. Although these symptoms did not improve for 1 week, displaced bone fragments of the greater sphenoid wing were removed via the lateral orbital approach. The patient had a good postoperative course with progressive improvement in eye movement over the next several weeks. The second patient was a 22-year-old man whose face was hit in a fight. CT disclosed medial displacement of the inner wall of the greater sphenoid wing of the left orbit. Although the patient also presented limited abduction of the left eye on admission, this symptom improved gradually. However, diplopia in all gaze directions and mild left proptosis did not improve. Therefore, the displaced inner wall of the greater sphenoid wing was reduced via the lateral orbital approach. The patient showed a good postoperative course with progressive improvement over the next several weeks. This type of orbital fracture, which is classified as an orbital blow-in fracture, is relatively rare. This type of greater sphenoid wing fracture is caused by buckling of the orbital wall secondary to severe compression of the orbital rim. Surgical treatment using the lateral orbital approach through a hemicoronal skin incision afforded a wider operative field and better cosmetic result.

Adolescent↗
PubMed2002

Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions.

Orbital skeletal injuries are frequently associated with other significant injuries and require a substantial surgical effort to correct. The use of a unified classification of orbital injury may better predict the surgical effort required to correct such injuries and help with future comparisons of results. In an attempt to summarize the principles of reconstruction of the orbital skeleton following trauma and introduce a unified classification system for orbital injuries, a retrospective review of all consecutive orbital reconstructions in a tertiary care teaching hospital was conducted. The nasoethmoidal region was involved in 32%, the zygomatic complex in 50%, and the frontal region in 28% of orbital fractures. Of the orbital walls, four walls were involved in 5%, three walls in 17%, two walls in 30%, and one wall in 53%. Associated ocular and neurologic injury was encountered in 33% and 57% of patients, respectively. Regions of fixation ranged from one to eight. Bone grafts were used in 20% and titanium mesh in 34% of the orbits. In general, the authors recommend an aggressive approach to orbital injuries, addressing all associated injuries simultaneously.

Adolescent↗
PubMed2006

Analysis of the postoperative outcome in 405 cases of orbital fracture using 2 synthetic orbital implants.

The purpose of this study was to analyze the postoperative complications according to the location (floor/medial wall/floor and medial wall) of the orbital fracture of 405 patients during the past 10 years and to investigate the possible alterative data in postoperative outcome in change with the application of 2 synthetic orbital implants: porous polyethylene (Medpor) and hydroxyapatite (Biocoral). The medical records of 405 patients were reviewed especially for enophthalmos, diplopia, sensory disturbance in the area of distribution of the infraorbital nerve, and postoperative complications originated from the implanted material itself, from March 1993 to July 2003. Of the 405 patients, 214 patients were operated with porous polyethylene and 191 patients with hydroxyapatite. The complication rate of the porous polyethylene group was 5.6%, which was not statistically different from that of the hydroxyapatite group (9.4%). Also by the location of fracture, the complication rate of both groups was similar statistically. In the comparative category, enophthalmos was more frequent statistically in patients treated with hydroxyapatite than those treated with porous polyethylene, and no other significant differences were in postoperative outcomes between the both groups. The information provided in this report should aid in using porous polyethylene or hydroxyapatite for reconstruction of the orbital fracture and in accomplishing better postoperative outcome.

Adolescent↗
PubMed2005

Chronic subperiosteal hematic cyst formation twelve years after orbital fracture repair with alloplastic orbital floor implant.

An 89-year-old female patient with a history of a left orbital floor fracture repair with synthetic implant 12 years prior, presented with a three-week history of blurry vision, inferior conjunctival chemosis and proptosis of the left eye. CT scan revealed a well-circumscribed subperiosteal lesion with superior elevation of the orbital floor implant. The patient underwent transconjunctival orbital surgery with removal of the implant and drainage of the subperiosteal hemorrhagic cyst. The patient had an uncomplicated postoperative course, with resolution of the proptosis, chemosis, and return of normal vision. This case represents an unusual late complication of orbital fracture repair with associated reduced visual acuity.

Aged↗
PubMed2004

Epidemiology and management of orbital fractures.

PURPOSE OF REVIEW: Orbital fractures are usually associated with ocular and intracranial injuries. The recent literature on orbital fractures is analyzed with emphasis on epidemiology, assessment, and surgical management. RECENT FINDINGS: In most countries, traffic accidents are the leading cause of orbital fractures. Orbitozygomatic fractures are extremely frequent but rarely addressed in the ophthalmic literature. CT scanning remains the gold standard for assessing orbital fractures, especially with the new CT technology (multislice CT), which has improved the acquisition of coronal images of the orbit without the need for hyperextension of the neck. Several different surgical strategies are used to repair orbital fractures. Porous polyethylene implants continue to be approved by most surgeons. SUMMARY: Orbital fractures are usually part of more complex midfacial trauma. Depending on the main characteristics of the trauma, orbital fractures are managed by different specialists who adopt distinct surgical approaches. Taking into consideration that most complications of these fractures are related to the globe, oculoplastic surgeons in collaboration with other medical specialists are in a prime position to assess and manage these cases.

Humans↗