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Abukhder M, Onions E, Flaherty E, Tarassoli S, Hassan MR, Whelan R. A systematic literature review and narrative synthesis on the use of autologous cartilage in the repair of orbital fractures. Ann Med Surg (Lond) 2024; 86:968-974. [PMID: 38333240 PMCID: PMC10849358 DOI: 10.1097/ms9.0000000000001598] [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: 08/22/2023] [Accepted: 11/27/2023] [Indexed: 02/10/2024] Open
Abstract
Introduction Fractures of the orbit are common injuries within the maxillofacial skeleton, and can often result in restrictions to ocular movement, diplopia, and enophthalmous if herniation of globe content occurs. Various studies have demonstrated the use of autologous cartilage grafts in the reconstruction of orbital fractures. Methods A systematic review protocol was registered with PROSPERO, and reported in accordance with the Preferred Reporting for Items for Systematic Reviews and Meta-Analyses. Comprehensive electronic search strategies of four databases were developed. Studies were screened according to the inclusion and exclusion criteria by two independent reviewers. Results Seven thousand one hundred seventy-one articles were identified following a comprehensive literature search. These articles were filtered for relevance and duplication, which reduced the number of articles to 16. A total of 259 patients underwent orbital reconstruction with the use of autologous cartilage. Conchal cartilage was harvested in 148 patients, auricular cartilage in 22 patients, nasoseptal cartilage in 72 patients, and costal cartilage in 17 patients. Thirty, seven, twelve, and four complications were observed in patients where cartilage was harvested from the concha, auricle, nasoseptum and rib, respectively. Most common complications included diplopia (n=23), infra-orbital para/anaesthesia (n=27), and enophthalmos (n=7). No failure of graft or donor site morbidity were observed in the studies. Conclusion Autogenous materials such as cartilage can be used as an alternative for orbital reconstruction. Cartilage was considered by the authors to provide adequate structural support to the orbital contents, and that it was easy to harvest, shape, and position.
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Affiliation(s)
| | | | - Erin Flaherty
- School of Medicine, Cardiff University, Neuadd Meirionnydd, Cardiff
| | - Sam Tarassoli
- Morriston Hospital, Heol Maes Eglwys, Morriston, Cwmrhydyceirw, Swansea
| | | | - Rhys Whelan
- Morriston Hospital, Heol Maes Eglwys, Morriston, Cwmrhydyceirw, Swansea
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Sidhu N, Agrawal S, Pushker N, Bhari N, Meel R, Bajaj MS. Autologous fat transfer for orbital volume augmentation in sockets with small nonseeing eyes. J Plast Reconstr Aesthet Surg 2023; 82:170-175. [PMID: 37182248 DOI: 10.1016/j.bjps.2023.02.024] [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: 07/06/2022] [Revised: 01/15/2023] [Accepted: 02/22/2023] [Indexed: 02/27/2023]
Abstract
OBJECTIVE End-stage ocular diseases usually end up with atrophic bulbi or phthisis bulbi leading to orbital volume loss which needs to be addressed. We studied the use of autologous fat for volume augmentation of the orbit because it is minimally invasive and allows early rehabilitation with the use of an artificial eye. DESIGN It was a prospective, interventional study. METHODS A total of 14 eyes of 14 patients with atrophic bulbi with shrinkage or phthisis bulbi with no perception of light (PL) and aged older than 18 years were included for the study purpose. Painful or inflamed eyes or suspected intraocular tumors were excluded. An autologous fat graft was obtained from the lower abdomen or buttocks and injected into the retrobulbar space using a 20-gauge cannula after adequate peribulbar anesthesia. Outcomes measures were patient satisfaction, change in Hertel's exophthalmometry, vertical and horizontal palpebral aperture, and socket volume. RESULTS Hertel exophthalmometry showed a significant improvement both with and without an artificial eye from 14.92 ± 2.3 mm to 16.71 ± 1.94 mm (p-value 0.003 without an artificial eye). The vertical palpebral aperture also showed a significant improvement from 5 ± 1.70 mm to 6.71 ± 1.58 mm (p-value < 0.001). There was a significant reduction in the socket volume from 1.22 ml to 0.39 ml (p-value < 0.001). No local or donor site complications were seen. CONCLUSIONS Autologous fat transfer is a minimally invasive, safe, and effective procedure for orbital volume augmentation in small, nonseeing eyes. The short-term outcome of our study was good in most patients and can be considered for such patients.
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Affiliation(s)
- Navneet Sidhu
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Sahil Agrawal
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - Neelam Pushker
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Neetu Bhari
- Dept. of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rachna Meel
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Mandeep S Bajaj
- Oculoplasty & Oncology Services, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
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Fox DM. Orbital Fat Injection: Technique and 5-Year Follow-Up. Aesthetic Plast Surg 2019; 43:123-132. [PMID: 30242462 DOI: 10.1007/s00266-018-1205-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/21/2018] [Indexed: 01/19/2023]
Abstract
BACKGROUND Orbital volume loss, early or late, is common after placement of an orbital implant or dermis fat graft, and there is currently no satisfactory long-lasting solution. Hyaluronic fillers are relatively easy to administer but are prone to migration and are temporary. Cannula-based orbital fat grafting has not gained the status of standard of care because of perceived low likelihood of success in the near term. This paper describes a technique for fat volume augmentation, its rationale, long-term follow-up, and a description of a complication unique to fat grafting in the orbit. METHODS Ten consecutive subjects with acquired anophthalmic enophthalmos were enrolled in two IRB (institutional review board)-approved protocols (10.27 and 12.01) undergoing a single session of autologous fat grafting to the orbit using a closed blunt cannula technique. Preoperative photography and non-contrast MRIs (magnetic resonance imaging) were obtained prior, immediately after, and at 1 year after injection. Yearly postoperative photography was performed on subjects with successful results. RESULTS Three of five subjects in IRB 10.27 clearly showed a clinically apparent increase in orbital volume at 1 year. One subject who failed to show improvement also sustained inadvertent injection into three extraocular muscles; she subsequently volunteered to enter IRB 12.01. Three of five subjects in IRB 12.01 did benefit, showing volume increase at 1 year, including the subject who had experienced intramuscular injection in 10.27. One subject in IRB 12.01 was lost to follow-up. Of the total of ten subjects enrolled, three showed no improvement and one was lost to follow-up; six subjects showed volume improvement at 1 year with two retaining the correction at 5 years and four showing variable diminution over 2-5 years. With the exception of the subject who sustained injection into extraocular muscles, none experienced complications. CONCLUSION A modified technique is recommended for orbital fat injection distinct from methods used elsewhere in the body. Theoretical limits of volumetric enhancement temper expectations in orbital fat grafting and should inform surgical planning. Cannula-based orbital fat grafting can be done safely and result in a gain of orbital fat volume at 1 year and in some cases up to 5 years. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Donald M Fox
- Department of Ophthalmology, New York Eye and Ear Infirmary, New York, NY, 10003, USA.
- Department of Plastic Surgery, New York Eye and Ear Infirmary, New York, NY, 10003, USA.
- Department of Ophthalmology, Manhattan Eye, Ear, and Throat Hospital, New York, NY, USA.
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He T, Huang Y, Chak JC, Klar RM. Recommendations for improving accuracy of gene expression data in bone and cartilage tissue engineering. Sci Rep 2018; 8:14874. [PMID: 30291289 PMCID: PMC6173755 DOI: 10.1038/s41598-018-33242-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2018] [Accepted: 09/26/2018] [Indexed: 12/15/2022] Open
Abstract
Autogenous tissue grafting remains the gold standard in the treatment of critical sized bone and certain cartilage defects, while the translation of tissue engineered osteogenesis or chondrogenesis from the lab bench into clinical practice, utilizing natural or synthetic biomimetic devices, remains challenging. One of the crucial underestimated reasons for non-translatability could be the imprecision and inconsistency of generated gene expression profiles, utilizing improperly optimized and standardized quantitative gene assays. Utilizing GeNorm for downstream qRT-PCR applications, the stability of reference genes in relation to optimal cDNA amounts was assessed on human bone marrow-derived mesenchymal and adipose-derived stem cells neat and made to differentiate into chondrocytes including normal human derived chondrocytes and muscle tissue from rats. Results showed that reference genes can vary substantially across separately and/or combined cell lines and/or tissue types including treatment parameters. The recommendations to all bone and cartilage tissue engineers utilizing qRT-PCR is not to assume that reference gene stability and quantity remain conserved across cell lines or tissue types but to always determine, for each new experiment, the stability and normalization quantity of reference genes anew.
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Affiliation(s)
- Tao He
- Laboratory of Biomechanics and Experimental Orthopaedics, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany.,Department of Orthopaedics, Renji Hospital, School of Medicine, Shanghai Jiaotong University, Shanghai, China
| | - Yijiang Huang
- Laboratory of Biomechanics and Experimental Orthopaedics, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany
| | - Juy Chi Chak
- Laboratory of Biomechanics and Experimental Orthopaedics, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany
| | - Roland Manfred Klar
- Laboratory of Biomechanics and Experimental Orthopaedics, Department of Orthopaedic Surgery, Physical Medicine and Rehabilitation, University Hospital of Munich (LMU), Munich, Germany.
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Abstract
BACKGROUND Posttraumatic enophthalmos is a relatively common problem following orbitozygomatic fractures. However, inadequate long-term results are frequently observed due to the difficulty of performing intraoperative fine adjustments to soft-tissue volume and orbital size and gradual absorption of some grafted materials. Here, the authors describe an efficient method of enophthalmos correction using sliced costochondral bone and cartilage combination grafts. METHODS From 2005 to 2011, the authors corrected enophthalmos in 12 patients using sliced costochondral grafts. The mean follow-up period was 13 months. For costochondral graft harvest, an approximately 5-cm skin incision was made directly above the seventh costal cartilage, the perichondrium was peeled back, and a small piece of rib bone and costal cartilage was harvested from the anterior part of the seventh rib bone and cartilage and cut into 2-mm-thick slices. A subciliary and/or transcaruncular incision was made in the affected side eyelid to expose the operating field, subperiosteal dissection was performed in the orbit and orbital floor. The cartilage chips were gradually grafted onto the dissected areas from the posterior orbit. RESULTS Aesthetically satisfactory results were obtained in all patients. No complications in the donor area were observed. Furthermore, no patients experienced a recurrence or deterioration of diplopia over the follow-up period. One patient experienced temporary high intraocular pressure, which spontaneously resolved with medication and eye drops. CONCLUSION The costochondral graft is adequate for the reconstruction of the fracture, easy to obtain, easily adaptable to the orbital walls, and has minimal morbidity at the donor site.
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Postoperative Improvement of Diplopia and Extraocular Muscle Movement in Patients With Reconstructive Surgeries for Orbital Floor Fractures. J Craniofac Surg 2016; 27:2043-2049. [DOI: 10.1097/scs.0000000000003192] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Moret A, Paré A, Sury F, Goga D, Laure B. [Posttraumatic enophthalmos correction by bone graft: Why the unpredictable results?]. ANN CHIR PLAST ESTH 2015; 60:276-83. [PMID: 25841767 DOI: 10.1016/j.anplas.2015.03.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 03/05/2015] [Indexed: 11/17/2022]
Abstract
PURPOSE OF THE STUDY Posttraumatic enophthalmos cause complex cosmetic problems to fix. In order to get better results, we wanted to calculate the volume of parietal bone graft needed to be put in place, know where to place it in orbit and study soft tissues' participation. PATIENTS AND METHOD In a retrospective study, we have calculated on scanner the volume of bone and soft tissue as well as the volume and the location of the graft. We have compared, between two groups ("good result" and "insufficient result"), graft volumes, taking into account differences in bone's volume between the healthy and the traumatized orbit. A comparison of the locations of the graft was also made. We were trying to find out if these factors were involved in the quality of the result. RESULTS Twenty-nine surgeries on 24 patients were analyzed. The average bone's volume of an orbit with enophthalmos was 24.76 cm(3) for 17.12 cm(3) of soft tissue. Retro-lens distance was the most reliable measurement method of enophthalmos (P=0.001). There was a trend to a more substantial over-correction in the group "good result". A significant increase (P=0.0008) of soft tissue volumes in the traumatized orbit was found. CONCLUSION This last result is surprising. Many authors believe that there is a scar retraction of soft tissues. But Kronish et al. showed an increase of the fat density and connective tissue. This, together with the assumption of a weathering of the ligament suspension of the globe, may affect our aesthetic results. MRI, ultrasound and anatomopathological studies would allow a better understanding of the fat, muscle and ligament pathophysiologies of an orbit with enophthalmos.
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Affiliation(s)
- A Moret
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France.
| | - A Paré
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
| | - F Sury
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
| | - D Goga
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
| | - B Laure
- Service de chirurgie maxillofaciale et plastique de la face, hôpital Trousseau, CHU de Tours, avenue de la République, 37170 Chambray-les-Tours, France
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Okumoto T, Koike G, Yoshimura Y. Secondary reconstruction of a mobile eye socket 30 years after enucleation of the eyeball for retinoblastoma: a case report. J Plast Reconstr Aesthet Surg 2013; 67:399-402. [PMID: 23916386 DOI: 10.1016/j.bjps.2013.07.025] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Accepted: 07/09/2013] [Indexed: 11/29/2022]
Abstract
A mobile eye socket is generally reconstructed by inserting an implant into the scleral pocket immediately after bulbar exenteration, or by attaching the extra-ocular muscles to the implanted artificial eyeball immediately after enucleation. However, exposure of the implanted material and other problems can occur. We achieved satisfactory reconstruction of a mobile eye socket by using an autogenous cartilage graft and a pericranial flap in a patient with long-standing anophthalmia due to enucleation. This case is presented with a review of the relevant literature.
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Affiliation(s)
- T Okumoto
- Department of Plastic and Reconstructive Surgery, Fujita Health University School of Medicine, Toyoake, Japan.
| | - G Koike
- Department of Plastic and Reconstructive Surgery, Fujita Health University School of Medicine, Toyoake, Japan
| | - Y Yoshimura
- Department of Plastic and Reconstructive Surgery, Fujita Health University School of Medicine, Toyoake, Japan
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Treatment of enophthalmos using corrective osteotomy with concomitant cartilage-graft implantation. J Plast Reconstr Aesthet Surg 2008; 63:42-53. [PMID: 19038594 DOI: 10.1016/j.bjps.2008.08.060] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2008] [Revised: 08/16/2008] [Accepted: 08/21/2008] [Indexed: 10/21/2022]
Abstract
Post-traumatic enophthalmos is a relatively common problem following orbitozygomatic fractures. Bony-volume expansion and soft-tissue atrophication are considered the main aetiological causes of this condition. Although most surgeons are familiar with the treatment principles in this field, inadequate long-term results are frequently observed. The cardinal reason is due to overt volume deficits, owing to suboptimal reduction and the ever-existing problem of soft-tissue atrophy. As such, it seemed logical that some treatment steps should be incorporated to increase the volume of orbital tissue. However, making fine adjustments to soft-tissue volume and orbital size during the same actual surgery is extremely difficult, if not impossible, which constitutes the biggest challenge in the treatment of enophthalmos. Based on the experiences from the management of seven patients with chronic enophthalmos (Group II), we could ascertain the average amount of the volume supplement required and were motivated to exploit a novel protocol of one-stage treatment for correction of disfiguring enophthalmos. In addition to the standard fracture-reduction methods, we use autologous, diced-cartilage graft to augment the orbital-tissue volume concomitantly for six consecutive patients (Group I) from 2004 to 2008. The actual quantities of inserted cartilage measured from 3.0 to 5.5ml in total. An aesthetically and functionally satisfactory result is attained in every case thus treated, with only one patient exhibiting a minor degree of overcorrection (1mm exorbitism). We thus advocate that this strategy is a viable option for preventing or rectifying late enophthalmos following severe orbitozygomatic fractures.
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Abstract
Enophthalmos is a relatively frequent and misdiagnosed clinical sign in orbital diseases. The knowledge of the different etiologies of enophthalmos and its adequate management are important, because in some cases, it could be the first sign revealing a life-threatening disease. This article provides a comprehensive review of the pathophysiology, evaluation, and management of enophthalmos. The main etiologies, such as trauma, chronic maxillary atelectasis (silent sinus syndrome), breast cancer metastasis, and orbital varix, will be discussed. Its objective is to enable the reader to recognize, assess, and treat the spectrum of disorders causing enophthalmos.
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Affiliation(s)
- Mehrad Hamedani
- Jules Gonin Eye Hospital--University of Lausanne, Lausanne, Switzerland
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Islamoglu K, Dikici MB, Ozgentas HE. Permanence of diced cartilage, bone dust and diced cartilage/bone dust mixture in experimental design in twelve weeks. J Craniofac Surg 2006; 17:905-8. [PMID: 17003619 DOI: 10.1097/01.scs.0000230616.56894.57] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
Bone dust and diced cartilage are used for contour restoration because their minimal donor site morbidity. The purpose of this study is to investigate permanence of bone dust, diced cartilage and bone dust/diced cartilage mixture in rabbits over 12 weeks. New Zealand white rabbits were used for this study. There were three groups in the study: Group I: 1 mL bone dust. Group II: 1 mL diced cartilage. Group III: 0.5 mL bone dust + 0.5 mL diced cartilage mixture. They were placed into subcutaneous tissue of rabbits and removed 12 weeks later. The mean volumes of groups were 0.23 +/- 0.08 mL in group I, 0.60 +/- 0.12 mL in group II and 0.36 +/- 0.10 mL in group III. The differences between groups were found statistically significant. In conclusion, diced cartilage was found more reliable than bone dust aspect of preserving its volume for a long period in this study.
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Affiliation(s)
- Kemal Islamoglu
- Department of Plastic and Reconstructive Surgery, Akdeniz University School of Medicine, 07059 Antalya, Turkey.
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Honda T, Sakurai H, Nakazawa H, Isago T, Nozaki M. Correction of Late Post-Traumatic Enophthalmos Using a Tissue Expander. Ann Plast Surg 2006; 56:686-8. [PMID: 16721086 DOI: 10.1097/01.sap.0000203263.13758.b3] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
We described a new technique to correct late post-traumatic enophthalmos using volume augmentation with a tissue expander. A 47-year-old male requiring enucleation with an implant replacement following orbital fracture with the globe injury had been complaining of persistent enophthalmos and cosmetic defect. Computed tomography scan demonstrated significant enophthalmos resulting from a volume discrepancy between an orbita and the orbital contents. To prevent worsening of the prosthesis motility with correction of enophthalmos, projection of the prosthetic globe was postoperatively adjusted by gradual inflation of an expander placed behind the enucleation implant. As a result enophthalmos was appropriately corrected without any change of the prosthesis motility.
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Affiliation(s)
- Takashi Honda
- Department of Plastic and Reconstructive Surgery, Tokyo Women's Medical University, Tokyo, Japan.
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Ozyazgan I, Eskitaşçioğlu T, Baykan H, Coruh A. Repair of Traumatic Orbital Wall Defects Using Conchal Cartilage. Plast Reconstr Surg 2006; 117:1269-76. [PMID: 16582799 DOI: 10.1097/01.prs.0000208301.69547.8b] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The authors' aim was to investigate the efficiency of conchal cartilage grafts in defective orbital wall fractures, which are encountered isolated or in combination with other orbitozygomatic fractures. The authors assessed, for this purpose, the follow-up results of patients treated by using conchal cartilage grafts. METHODS Ten patients who had defective orbital wall fractures and were treated by using conchal cartilage graft among those treated for facial fractures in the authors' clinic were included in the study. The wall defects in the patients were detected either with preoperative radiologic images or with orbital exploration performed to look for a possible defect accompanying the fracture with orbital extension during the operation. In all patients (four isolated and six combined orbital fractures), who had defects varying from 100 to 400 mm, conchal cartilage grafts were adapted to the defect. In the postoperative follow-up, Hertel exophthalmometry was also performed together with clinical examination so that enophthalmos that might develop as a complication could be assessed. RESULTS In the postoperative period, cartilage graft was palpated slightly in two patients at the edge of the infraorbital rim. Limitation in eye movement, diplopia, and enophthalmos did not occur in our patients, except for one who reported to us 1 year after the primary trauma. No complication in the donor area was observed. CONCLUSIONS Conchal cartilage could be considered one of the autogenous materials among those materials suitable for the repair of defective orbital wall fractures that are not oversized. It has the advantages of being adequate for reconstruction of the fracture, easy to obtain, easily adaptable to the orbital walls, and having minimum morbidity at the donor site.
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Affiliation(s)
- Irfan Ozyazgan
- Department of Plastic and Reconstructive Surgery, Erciyes University, Faculty of Medicine, Kayseri, Turkey.
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Lee YH, Jin US. The Operation of Facial Bone Fractures. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2006. [DOI: 10.5124/jkma.2006.49.9.817] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Yoon Ho Lee
- Department of Plastic and Reconstruction Surgery, Seoul National University College of Medicine, Korea. ,
| | - Ung Sik Jin
- Department of Plastic and Reconstruction Surgery, Seoul National University College of Medicine, Korea. ,
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Goldberg RA, Saulny S, McCann JD, Yuen VH. Orbital volume augmentation for late enophthalmos using the deep lateral wall. ARCHIVES OF FACIAL PLASTIC SURGERY 2003; 5:256-8. [PMID: 12756121 DOI: 10.1001/archfaci.5.3.256] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Orbital volume augmentation to address enophthalmos and hollowing of the superior sulcus has been described with a variety of materials and from a variety of approaches.(1-4) A common location for volume augmentation is the inferomedial orbital wall; this surface is often the one that was expanded related to orbital trauma, and it is easily accessed through hidden conjunctival or caruncular incisions.
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Affiliation(s)
- Robert Alan Goldberg
- Division of Orbital and Ophthalmic Plastic Surgery, Jules Stein Eye Institute, Department of Ophthalmology, UCLA School of Medicine, 100 Stein Plaza, Los Angeles, CA 90095-7006, USA
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