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Lubamba GP, Dai X, Song Z, Al-Shujaa EA, Guan J, Wang X, Isouradi-Bourley JPS, Zhang Y, Milolo AM, Bushabu FN, Xu P, Che D. Assessment of quality of life in patients treated for orbital fractures. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2023; 124:101486. [PMID: 37105493 DOI: 10.1016/j.jormas.2023.101486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2023] [Accepted: 04/17/2023] [Indexed: 04/29/2023]
Abstract
PURPOSE This study aimed to assess the quality of life (QOL), before and after surgery, of patients who underwent open reduction and internal fixation for orbital fractures. STUDY DESIGN A prospective study. PARTICIPANTS AND SETTING The self-report outcome measures of 50 patients treated at the Department of Oral and Maxillofacial Surgery of the Second Affiliated Hospital of Jiamusi University from January 2016 to June 2019 were prospectively collected. MAIN MEASURES The quality of life was assessed using four patient-reported outcome measures (PROMs): the 15D questionnaire, Oral Health Impact Profile-14 (OHIP-14), Hospital Anxiety and Depression Scale (HADS), and 36-item Short Form Survey (SF-36). Both descriptive and comparative data analyses were calculated. RESULTS Zygomaticomaxillary complex fractures were the most encountered (40.3%). The total OHIP-14 scores before and after treatment were 1.72 and 1.68, respectively. Vision, breathing, sleeping, eating, usual activities, discomfort and symptoms, and vitality showed minimal changes in the 15D questionnaire. The HADS scores were ranged from 0 to 7, indicating no anxiety or depression. The comparison of SF-36 scores after 3 months and after ≥6 months of treatment revealed no significant difference. CONCLUSIONS Patients' QOL was minimally impacted by orbital fractures and their treatments. The severity of the negative impact can be minimized if appropriate management strategies are taken.
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Affiliation(s)
- Grace Paka Lubamba
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China; Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo; Department of Head and Neck Oncology, West China Hospital of Stomatology, Sichuan University, Chengdu, China
| | - Xinpeng Dai
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Zhenyu Song
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Eissa A Al-Shujaa
- Department of Oral and Maxillofacial Surgery, State Key Laboratory of Oral Diseases and National Clinical Research Centre for Oral Diseases, West China Hospital of Stomatology, Sichuan University, Chengdu, Sichuan, China
| | - Jian Guan
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China.
| | - Xinyu Wang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | | | - Yanqi Zhang
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Augustin Mantshumba Milolo
- Department of Prosthodontics, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Fidele Nyimi Bushabu
- Department of Oral and Maxillofacial Surgery, Faculty of Dental Medicine, University of Kinshasa, Kinshasa, People's Republic of Congo
| | - Pengkun Xu
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
| | - Di Che
- Department of Oral and Maxillofacial Surgery, Second Affiliated Hospital of Jiamusi University, 522 Hong Qi Street, P.C., Jiamusi 154004, China
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Cellina M, Cè M, Marziali S, Irmici G, Gibelli D, Oliva G, Carrafiello G. Computed tomography in traumatic orbital emergencies: a pictorial essay-imaging findings, tips, and report flowchart. Insights Imaging 2022; 13:4. [PMID: 35022818 PMCID: PMC8755868 DOI: 10.1186/s13244-021-01142-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 12/08/2021] [Indexed: 11/10/2022] Open
Abstract
Computed tomography (CT) is considered the gold standard technique for the assessment of trauma patients with suspected involvement of the eye and orbit. These traumas can result in dramatic consequences to visual function, ocular motility, and aesthetics. CT is a quick and widely available imaging modality, which provides a detailed evaluation of the orbital bony and soft tissue structures, an accurate assessment of the globes, and is used to guide the patients’ treatment planning. For a timely and accurate diagnosis, radiologists should be aware of fracture patterns and possible associated complications, ocular detachments and hemorrhages, and different appearances of intraorbital foreign bodies. This educational review aims to describe all post-traumatic orbital abnormalities that can be identified on CT, providing a list of tips and a diagnostic flowchart to help radiologists deal with this complex condition.
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Affiliation(s)
- Michaela Cellina
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20121, Milan, Italy
| | - Maurizio Cè
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy
| | - Sara Marziali
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy.
| | - Giovanni Irmici
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy
| | - Daniele Gibelli
- Dipartimento Di Scienze Biomediche Per La Salute, Università Degli Studi Di Milano, Via Mangiagalli 31, 20133, Milan, Italy
| | - Giancarlo Oliva
- Radiology Department, Fatebenefratelli Hospital, ASST Fatebenefratelli Sacco, Piazza Principessa Clotilde 3, 20121, Milan, Italy
| | - Gianpaolo Carrafiello
- Scuola di Specializzazione in Radiodiagnostica, Università degli Studi di Milano, Via Festa del Perdono, 7, 20122, Milan, MI, Italy.,Radiology Department, Policlinico di Milano Ospedale Maggiore, Fondazione IRCCS Ca' Granda, Via Francesco Sforza, 35, 20122, Milan, MI, Italy
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Technological Integration of Virtual Surgical Planning, Surgical Navigation, Endoscopic Support and Patient-Specific Implant in Orbital Trauma. J Maxillofac Oral Surg 2021; 20:459-463. [PMID: 34408374 DOI: 10.1007/s12663-020-01423-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 07/11/2020] [Indexed: 10/23/2022] Open
Abstract
Currently, we have different technologies and techniques that improve the results in orbital trauma. However, there are few studies that study the technological integration in orbital trauma and the synergism of all the techniques. For this reason, the objective of this case is to illustrate the management of orbital trauma by integrating endoscopic support, virtual surgical navigation, patient-specific implant, virtual surgical planning in the management of a sequel due to insufficient reconstruction of orbital volume.
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Transoral Endoscopic Plating for Orbital Blowout Fractures. J Craniofac Surg 2021; 32:2835-2839. [PMID: 34183635 DOI: 10.1097/scs.0000000000007726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
ABSTRACT 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.
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De-Moraes SLC, Pereira RDS, Afonso AMDP, Mattos RP, Ribeiro da Silva J, Santos RG, Calasans-Maia MD. A prospective study of resolution of post-traumatic orbital complications using PRECLUDE® MVP: A randomized controlled trial. Ann Med Surg (Lond) 2021; 61:139-144. [PMID: 33456773 PMCID: PMC7797472 DOI: 10.1016/j.amsu.2020.12.021] [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] [Received: 11/04/2020] [Revised: 12/13/2020] [Accepted: 12/15/2020] [Indexed: 11/24/2022] Open
Abstract
Orbital fractures alone represent 10% up to 25% of all facial fractures, but when they are associated with other fractures of the middle-third of the face, their incidence can increase up to 55%. This study aimed to identify whether the size of the orbital defect based on the classification by Jaquiéry et al. influenced the resolution of post-traumatic complications after orbital wall reconstruction using PRECLUDE®MVP alone or in combination with a titanium mesh or autogenous bone graft. Thirty-five orbits were categorized into four groups on the basis of the size of the defect and the operative techniques: group 1 contained 16 Jaquiéry class I orbits treated only with PRECLUDE®MVP; group 2 included eight class II orbits treated with PRECLUDE®MVP along with autogenous bone graft harvested from the calvaria or a titanium mesh; group 3 included five class III orbits and group 4 included six class IV orbits that were treated the same way as those in group 2. Spearman correlation showed that the use PRECLUDE®MVP didn't improve the post traumatic complications for big orbital defects due to the three-dimensional anatomical changes that occurred by neurologic lesions and lipolysis of the orbital contents.
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Affiliation(s)
| | | | | | - Ricardo Pereira Mattos
- Clinic for Cranio-Maxillofacial & Reconstructive Surgery, Hospital São Francisco, Rio de Janeiro, Brazil
| | | | - Roberto Gomes Santos
- Clinic for Cranio-Maxillofacial & Reconstructive Surgery, Hospital São Francisco, Rio de Janeiro, Brazil
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Aman HM, Alenezi A, Ducic Y, Reddy LV. Secondary Reconstruction of the Zygomaticomaxillary Complex. Semin Plast Surg 2020; 34:254-259. [PMID: 33380910 DOI: 10.1055/s-0040-1721761] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Zygomaticomaxillary (ZMC) fractures are the second most common facial fractures after nasal bone fractures. The zygoma, with its location and multiple points of articulations, lends itself to both facial structure and esthetics. Secondary ZMC deformities are complications of inadequate primary correction, delayed repair, or lack of repair. Secondary revisions of ZMC aim to correct ZMC displacement and projection and to address orbital discrepancies. Extensive correction involving significant orbital and malar defects requires zygomatic repositioning osteotomies and would greatly benefit from the utilization of virtual surgical planning, intraoperative navigation, and imaging. Minor corrections in malar projection can be corrected by onlay grafting and soft tissue augmentation and resuspension. Isolated or minor orbital corrections can be managed by autogenous or alloplastic material to restore lost orbital volume and anatomy.
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Affiliation(s)
- Hessah M Aman
- Department of Oral and Maxillofacial, College of Dentistry, Texas A&M Health Science Center, Dallas, Texas
| | - Abdulrahman Alenezi
- Department of Otolaryngology - Head and Neck Surgery, University of Manitoba, Manitoba, Canada
| | - Yadranko Ducic
- Otolaryngology and Facial Plastic Surgery Associates, Fort Worth, Texas
| | - Likith V Reddy
- Department of Oral and Maxillofacial, College of Dentistry, Texas A&M Health Science Center, Dallas, Texas
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Management of an Unusual Blow-In Orbital Roof Fracture Associated an Intracranial Hematoma. J Craniofac Surg 2020; 32:e101-e102. [PMID: 32890166 DOI: 10.1097/scs.0000000000006783] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
ABSTRACT Pure orbital wall fractures represent until 25% of the facial fractures and its reconstruction it's considering a challenge for the maxillofacial surgeons. There are many biomaterials used to repair these fractures according to the literature however, the most common are the titanium mesh and autogenous bone graft.The aim of this work is to report a rare case of blow-in roof orbital fracture associated to an intracranial hematoma in the cranium base.
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9
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Olsson AB, Dillon J, Kolokythas A, Schlott BJ. Reconstructive Surgery. J Oral Maxillofac Surg 2019; 75:e264-e301. [PMID: 28728733 DOI: 10.1016/j.joms.2017.04.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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10
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Senese O, Boutremans E, Gossiaux C, Loeb I, Dequanter D. Retrospective analysis of 79 patients with orbital floor fracture: outcomes and patient-reported satisfaction. Arch Craniofac Surg 2018; 19:108-113. [PMID: 29996639 PMCID: PMC6057128 DOI: 10.7181/acfs.2018.01837] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Accepted: 06/18/2018] [Indexed: 12/01/2022] Open
Abstract
Background The aim of our retrospective study is to evaluate the management of isolated orbital floor fractures considering the clinical, functional and aesthetic results according to the surgical approach and the type of materials used. Methods Retrospectively, clinical, radiological, surgical, and ophthalmological data from 79 patients were collected from January 2010 to December 2016. Furthermore, included patients were interrogated on functional and aesthetic satisfaction. Results The main causes of trauma were physical aggression followed by accidents. The median time between trauma and surgery was 4 days. The most common surgical approaches were the subciliary and the transconjunctival ones. Alloplastic materials were used in 75 patients. In two patients, we used a combination of two grafts. Patients experienced minor immediate complications. On follow-ups, none of our patients suffered from ocular movement restrictions. Patients treated by subciliary approach had higher risk of retractile scaring compared to other surgical approaches. In our study, patients agreed to complete a questionnaire assessing functional and aesthetic outcomes with a high satisfaction score. No association between the implant material used and the results has been assessed. Conclusion This study describes the results of orbital floor reconstructions. Despite a variety of materials used and surgical approaches performed, we believe that the transconjunctival approach is the most suitable option with a high satisfaction score.
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Affiliation(s)
- Olivier Senese
- Department of Maxillofacial Surgery, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Edward Boutremans
- Department of Maxillofacial Surgery, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Caroline Gossiaux
- Department of Maxillofacial Surgery, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Isabelle Loeb
- Department of Maxillofacial Surgery, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium
| | - Didier Dequanter
- Department of Maxillofacial Surgery, CHU Saint Pierre, Université Libre de Bruxelles, Brussels, Belgium
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11
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Christensen BJ, Zaid W. Inaugural Survey on Practice Patterns of Orbital Floor Fractures for American Oral and Maxillofacial Surgeons. J Oral Maxillofac Surg 2015; 74:105-22. [PMID: 26475972 DOI: 10.1016/j.joms.2015.09.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 09/22/2015] [Accepted: 09/22/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE In recent years, several studies have reported on practitioners' preferences for the treatment of orbital floor fractures, showing widely varying practice patterns. The purpose of the present study was to identify the practice patterns among oral and maxillofacial surgeons involved in the management of orbital floor fractures in the United States and compare them with the available published data. MATERIALS AND METHODS An anonymous survey was created and electronically mailed to surgeons. We also reviewed the published data on orbital floor fractures using a PubMed and MEDLINE search. The responses to the survey were analyzed using descriptive statistics. RESULTS The factors that had the greatest influence on the surgeon's decision to operate were a defect size > 2 cm2, enophthalmos, entrapment, and persistent diplopia. The most common surgical approach reported was a preseptal transconjunctival approach (32.0%), followed by the subciliary (27.9%) and postseptal transconjunctival (26.2%) approaches. The most commonly reported implant for orbital reconstruction was titanium (65.4%), followed by Medpor (43.7%) and composite Medpor and titanium (26.4%). The review of the published data showed a consensus among many of the operative indications mentioned, including a large defect size, enophthalmos, clinical entrapment, and persistent diplopia. CONCLUSIONS Oral and maxillofacial surgeons in the United States have a wide range of practice habits in the management of orbital floor fractures. Although the quality of the available evidence is poor, it supports a consistent approach to the management of orbital floor fractures in terms of the indications and surgical approach. The choice of reconstructive material and timing of repair remain more controversial. A clear need exists for improvement in the available data to help guide and set standards of care for the specialties managing orbital floor fractures.
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Affiliation(s)
- Brian J Christensen
- Resident, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA
| | - Waleed Zaid
- Assistant Professor, Department of Oral and Maxillofacial Surgery, Louisiana State University Health Sciences Center, New Orleans, LA.
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Tomasetti P, Metzler P, Jacobsen C. Isolated inferior rectus muscle rupture after blunt orbital trauma. J Surg Case Rep 2013; 2013:rjt076. [PMID: 24963904 PMCID: PMC3813725 DOI: 10.1093/jscr/rjt076] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
A 44-year-old man was referred to our department with diplopia, periorbital swelling and haematoma of the left eye after orbital trauma due to a punch. During the examination, mild enophthalmos, hypertropia and a total absence of infraduction were observed. An orbital computed tomography (CT) scan demonstrated a left orbital floor blow-out fracture, with caudal herniation of periorbital fat and rectus inferior muscle. Repair was performed under total anaesthesia with placement of a Titan mesh. The following days were marked by the persistence of diplopia without improvement of infraduction. A postoperative, 0.5 mm CT scan highlighted a complete rupture of the inferior rectus muscle, not seen before operation, by a 1.0 mm-sliced CT. In this case, orthoptic therapy was undertaken with good results after 6 months and without need of a second repair.
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Affiliation(s)
- Patrick Tomasetti
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Philipp Metzler
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
| | - Christine Jacobsen
- Department of Cranio-Maxillofacial and Oral Surgery, University Hospital Zurich, Zurich, Switzerland
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Late Correction of Orbital-Zygomatic-Maxillary Fractures Combined With Orbital Wall Fractures. J Craniofac Surg 2012; 23:1672-6. [DOI: 10.1097/scs.0b013e318266f963] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Computer-Assisted Navigational Surgery Improves Outcomes in Orbital Reconstructive Surgery. J Craniofac Surg 2012; 23:1567-73. [DOI: 10.1097/scs.0b013e318260ef33] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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[Orbitocutaneous fistula after orbital reconstruction]. HNO 2012; 61:344-6. [PMID: 22733279 DOI: 10.1007/s00106-012-2529-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
A 73-year old man presented with a lesion inferior to his left medial canthus with discharge and headache. Fifteen years previously, the patient had undergone reduction of an orbital fracture and reconstruction of the orbit with silicone. An orbitocutaneous fistula was found to originate from the implant which was displaced in the ethmoid, obstructing frontal sinus outflow. Symptoms disappeared after explantation of the implant, reconstruction of the orbit with a titanium plate and frontal sinus surgery. Although the use of silicone in facial trauma has declined, complications have to be expected even years after implantation.
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