1
|
Wu E, Sun J, Zhou G, Wu W. Endoscopic transnasal drainage for orbital implantation cyst after orbital wall reconstruction. Indian J Ophthalmol 2021; 69:1942-1944. [PMID: 34146062 PMCID: PMC8374787 DOI: 10.4103/ijo.ijo_3460_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
An implantation cyst after orbital wall reconstruction may present as a late complication, which can cause local pain, proptosis, diplopia, and vision impairment. Previous surgical strategies prefer transconjunctival or subtarsal approach for cyst drainage, a similar approach to orbital wall reconstruction. These strategies may have risk of secondary infection. Herein, we propose an endoscopic transnasal surgical approach, through which the removal of implant and cyst drainage can be performed conveniently. The residual, medial single-layer cyst wall is generally strong enough to support the orbital soft tissues without the need for a new implant. We believe this surgical approach can simplify the procedure, reduce the complications, and prevent cyst recurrence.
Collapse
Affiliation(s)
- Ende Wu
- The Mini-Invasive Orbital & Oculoplastic Surgery Center, The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Jiaying Sun
- The Mini-Invasive Orbital & Oculoplastic Surgery Center, The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Guangming Zhou
- The Mini-Invasive Orbital & Oculoplastic Surgery Center, The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| | - Wencan Wu
- The Mini-Invasive Orbital & Oculoplastic Surgery Center, The Eye Hospital, School of Ophthalmology and Optometry, Wenzhou Medical University, Wenzhou, China
| |
Collapse
|
2
|
Theofilou NE, Becker M, Lombardi T, Scolozzi P. Posttraumatic Respiratory Epithelial Orbital Cyst With Intracranial Extension: A Unique Association. Ophthalmic Plast Reconstr Surg 2021; 37:e25-e28. [PMID: 32427731 DOI: 10.1097/iop.0000000000001714] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Respiratory epithelial orbital cysts (REOC) are rare benign lesions that may be either congenital or acquired. Congenital REOC develop from embryological epithelial rests and are known as choristomas, whereas acquired forms develop from the sequestration of respiratory epithelium from adjacent paranasal sinuses following trauma and/or fracture repair procedures. The final diagnosis can be difficult because congenital and acquired REOC and mucoceles share the same features histologically. The involvement of the paranasal sinuses, which is the landmark of mucoceles, does not occur with REOC. Moreover, the intracranial extension, which is known for mucoceles, has never been reported for REOC. Respiratory epithelial orbital cysts warrant prompt radical surgical resection given that these lesions may lead to a progressive intracranial progression and/or recurrent infection with a potential for meningitis or cerebral abscess. The authors report a unique case of a patient with an intraorbital posttraumatic respiratory epithelial orbital cyst associated with intracranial involvement.
Collapse
Affiliation(s)
| | - Minerva Becker
- Division of Radiology, Department of Imaging and Medical Informatics
| | | | - Paolo Scolozzi
- Division of Oral and Maxillofacial Surgery, Department of Surgery, University of Geneva & University Hospitals of Geneva, Geneva, Switzerland
| |
Collapse
|
3
|
Oh SY, Choi JS, Lim JS, Kim MC. Eyeball deviation by orbital mucocele after midface sinus injury. Arch Craniofac Surg 2020; 21:53-57. [PMID: 32126622 PMCID: PMC7054188 DOI: 10.7181/acfs.2019.00605] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2019] [Accepted: 12/06/2019] [Indexed: 11/30/2022] Open
Abstract
A mucocele is an epithelium-lined, mucus-filled cavity in the paranasal sinuses. Mucocele may develop due to scarring and obstruction of the sinus ostium caused by midface sinus trauma, such as orbital bone fracture or endoscopic sinus surgery. The authors report two cases of orbital mucocele as complications following midface sinus injury (endoscopic sinus surgery in one case, and orbital fracture repair in the other). In both cases, imaging studies showed a large orbital mucocele accompanied by bony erosion and orbital wall remodeling, compressing the ocular muscle. Using an open approach, the lesion was excised and marsupialized. The symptoms resolved, and the postoperative eyeball position was normal. Orbital mucocele may cause serious complications such as ocular symptoms, orbital cellulitis, osteomyelitis, and the formation of an abscess with the potential to invade the brain. Therefore, surgeons should consider the possibility of mucocele as a late complication of surgery and initiate an immediate work-up and surgical treatment if needed.
Collapse
Affiliation(s)
- Se Young Oh
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Ji Seon Choi
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Jin Soo Lim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Min Cheol Kim
- Department of Plastic and Reconstructive Surgery, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| |
Collapse
|
4
|
Kohyama K, Arisawa K, Arisawa Y, Morishima Y. Symptomatic cystic lesions as late post-operative complications of silicone implantation for orbital wall fracture reconstruction: A long-term follow-up study. J Plast Reconstr Aesthet Surg 2019; 73:344-350. [PMID: 31810891 DOI: 10.1016/j.bjps.2019.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2019] [Accepted: 09/09/2019] [Indexed: 11/20/2022]
Abstract
Although complications of silicone implants and development of new materials have led to a decline in the use of silicone implants for orbital wall fractures, their advantages are still reported. The overall incidence, risk factor and treatment of silicone implant complications, especially those caused by cystic lesions, remain unclear. We aimed to report our experiences of patients with orbital wall fractures that were reconstructed with silicone implants and followed up for a long period. We retrospectively analysed 56 patients who underwent surgical repair of the orbital wall fractures with a silicone implant from January 2006 to December 2017 and were followed up for more than 6 months. A chart review and the assessment of demographic and surgical factors, among others, were performed. There were 47 eligible patients in this study, and the mean post-operative follow-up period was 83.1 months. When comparing the results obtained 6 months post-operatively with those obtained at the final follow-up, the overall complication rate increased from 5/47 to 13/47, and the silicone implant removal rate increased from 0/47 to 10/47. The symptoms caused by the cystic lesions were managed through silicone implant removal. The immediate post-operative bleeding was significantly associated with silicone implant survival (p = 0.008). Silicone implants used for orbital wall fractures were never stabilised during the long-term study. Much attention should be paid during the follow-up of high-risk patients. Most late complications were caused by cystic lesions, and only silicone implant removal would be sufficient and considered safe as the initial intervention.
Collapse
Affiliation(s)
- Keishi Kohyama
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan
| | - Koki Arisawa
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan
| | - Yuko Arisawa
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan
| | - Yoko Morishima
- Department of Plastic and Reconstructive Surgery, Ogaki Municipal Hospital, 4-86 Minaminokawa-cho Ogaki City, Gifu Pref 5038502, Japan.
| |
Collapse
|
5
|
Xu QH, Yu JH, Wang YH, Wang AA, Liao HF. Analysis of the effect of repair materials for orbital blowout fracture on complications. Int J Ophthalmol 2019; 12:1746-1750. [PMID: 31741864 DOI: 10.18240/ijo.2019.11.13] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 08/20/2019] [Indexed: 01/14/2023] Open
Abstract
AIM To investigate the effect of repair materials for orbital blowout fractures on the occurrence of postoperative complications. METHODS The clinical data and follow-up data of 54 subjects with orbital blowout fractures were retrospectively analyzed. The study was divided into three groups according to the used repair materials: titanium mesh (16 cases), Medpor (12 cases), and Medpor titanium mesh (26 cases). All test data were analyzed using the SPSS version 23.0 statistical software. The mean age and duration of disease between the groups were compared through one-way analysis of variance. The Chi-square (χ 2) test was used to compare the number of males and females, different fracture types, and different surgical approaches among groups. The χ 2 test was used to compare the frequencies for complications in each group. RESULTS The baseline characteristics of age and gender in each group were matched (F=1.763, P=0.172; χ 2=0.026, P=0.987). In addition, there was no difference in the type of fracture and surgical approach (χ 2=0.460, P=0.977; χ 2=0.691, P=0.952), or the incidence of complications (χ 2=0.081, P=0.960) between the three groups. CONCLUSION Although there is no difference in effect of various repair materials on the incidence of complications, the effect of repair materials on postoperative complications of orbital blowout fractures should not be ignored.
Collapse
Affiliation(s)
- Qi-Hua Xu
- Department of Ocular Trauma, Orbital Disease, Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Jin-Hai Yu
- Jiangxi Research Institute of Ophthalmology & Visual Sciences, Nanchang 330006, Jiangxi Province, China
| | - Yao-Hua Wang
- Department of Ocular Trauma, Orbital Disease, Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - An-An Wang
- Department of Ocular Trauma, Orbital Disease, Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| | - Hong-Fei Liao
- Department of Ocular Trauma, Orbital Disease, Affiliated Eye Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China
| |
Collapse
|
6
|
A Pediatric Patient With an Orbital Respiratory Epithelial Cyst. J Craniofac Surg 2017; 28:2098-2100. [PMID: 28968330 DOI: 10.1097/scs.0000000000004169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Respiratory epithelial cysts are rare orbital cysts that can arise secondary to choristomatous rests of respiratory epithelium. Approximately 15 congenital cases have been described in the literature, making it a rare disease entity. We present a case of a 14-month-old Middle Eastern male with a right infraorbital respiratory epithelial cyst. Magnetic resonance imaging of the brain and orbits revealed a right infraorbital cyst hyperintense on T1-weighted images and followed fluid density on T2-weighted images. This cyst was noted to displace the globe superiorly and inferior rectus muscle laterally. This cyst was excised using a transconjunctival approach. Histologically, the cyst wall was lined by ciliated columnar cells with interspersed mucus-containing cells and ciliated transitional epithelium was present, establishing the diagnosis of respiratory epithelial cyst. To our knowledge, this is the youngest patient with a respiratory epithelial cyst of the orbit reported in the literature.
Collapse
|
7
|
Lee CA, Kang SJ, Yun JY, Sun H. Late Complication of a Silicone Implant Thirty Years after Orbital Fracture Reconstruction. Arch Craniofac Surg 2017; 18:137-140. [PMID: 28913322 PMCID: PMC5556896 DOI: 10.7181/acfs.2017.18.2.137] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Revised: 05/14/2017] [Accepted: 05/15/2017] [Indexed: 11/11/2022] Open
Abstract
Alloplastic materials used for orbital fracture reconstruction can induce complications, such as infection, migration, extrusion, intraorbital hemorrhage, and residual diplopia. Silicone is one of the alloplastic materials that has been widely used for decades. The author reports a rare case of spontaneous extrusion of a silicone implant that was used for orbital fracture reconstruction 30 years earlier. A 50-year-old man was admitted to the emergency room for an exposed substance in the lower eyelid area of the left eye, which began as a palpable hard nodule a week earlier. The exposed material was considered to be implant used for previous surgery. Under general anesthesia, the implant and parts of the fibrous capsule tissue were removed. Several factors hinder the diagnosis of implant extrusions that occur a long period after the surgery. So, surgeons must be aware that complications with implants can still arise several decades following orbital fracture reconstruction, even without specific causes.
Collapse
Affiliation(s)
- Chi An Lee
- Department of Plastic and Reconstructive Surgery, Busan-Baik Hospital, Inje University School of Medicine, Busan, Korea
| | - Seok Joo Kang
- Department of Plastic and Reconstructive Surgery, Busan-Baik Hospital, Inje University School of Medicine, Busan, Korea
| | - Ji Young Yun
- Department of Plastic and Reconstructive Surgery, Busan-Baik Hospital, Inje University School of Medicine, Busan, Korea
| | - Hook Sun
- Department of Plastic and Reconstructive Surgery, Busan-Baik Hospital, Inje University School of Medicine, Busan, Korea
| |
Collapse
|