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Park JS, In SM, Lee KI. Endoscopic endonasal reduction of medial and inferior blow-out fractures treated with application of Nasopore Forte plus. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Kim SM, Kim CK, Jo DI, Lee MC, Kim JN, Choi HG, Shin DH, Kim SH. A useful additional medial subbrow approach for the treatment of medial orbital wall fracture with subciliary technique. Arch Craniofac Surg 2019; 20:101-108. [PMID: 31048647 PMCID: PMC6505438 DOI: 10.7181/acfs.2019.00178] [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: 04/10/2019] [Accepted: 04/20/2019] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND To date, a variety of surgical approaches have been used to reconstruct the medial orbital wall fracture. Still however, there is still a controversy as to their applicability because of postoperative scars, injury of anatomical structures and limited visual fields. The purpose of this study was to introduce a useful additional medial subbrow approach for better reduction and securement more accurate implant pocket of medial orbital wall fracture with the subciliary technique. METHODS We had performed our technique for a total of 14 patients with medial orbital wall fracture at our medical institution between January 2016 and July 2017. All fractures were operated through subciliary technique combined with the additional medial subbrow approach. They underwent subciliary approach accompanied by medial wall dissection using a Louisville elevator through the slit incision of the medial subbrow procedure. This facilitated visualization of the medial wall fracture site and helped to ensure a more accurate pocket for implant insertion. RESULTS Postoperative outcomes showed sufficient coverage without displacement. Twelve cases of preoperative diplopia improved to two cases of postoperative diplopia. More than 2 mm enophthalmos was 14 cases preoperatively, improving to 0 case postoperatively. Without damage such as major vessels or extraocular muscles, enophthalmos was corrected and there was no restriction of eyeball motion. CONCLUSION Our ancillary procedure was useful in dissecting the medial wall, and it was a safe method as to cause no significant complications in our clinical series. Also, there is an only nonvisible postoperative scar. Therefore, it is a recommendable surgical modality for medial orbital wall fracture.
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Affiliation(s)
- Seung Min Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Cheol Keun Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Dong In Jo
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
| | - Myung Chul Lee
- Department of Plastic and Reconstructive Surgery, Konkuk University Seoul Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Ji Nam Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Seoul Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Hyun Gon Choi
- Department of Plastic and Reconstructive Surgery, Konkuk University Seoul Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Dong Hyeok Shin
- Department of Plastic and Reconstructive Surgery, Konkuk University Seoul Hospital, Konkuk University School of Medicine, Seoul, Korea
| | - Soon Heum Kim
- Department of Plastic and Reconstructive Surgery, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Chungju, Korea
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A Comparison of Endoscopic Reduction for Medial Blowout Fractures Using a Bioresorbable Panel and Silastic Sheet. J Craniofac Surg 2019; 30:e160-e163. [PMID: 30664556 DOI: 10.1097/scs.0000000000005083] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The aim of the study was to compare the effectiveness of endoscopic endonasal reduction using a bioresorbable panel and silastic sheet packed with Merocel for blowout fractures of the medial orbital wall. DESIGN Retrospective study. METHODS The study group consisted of 147 patients who underwent endoscopic endonasal reduction of a blowout fracture of the medial orbital wall between January 2005 and December 2016. Fifty-seven fractures were repaired using a splint formed by a silastic sheet and Merocel (splint group), whereas 90 fractures were repaired using a bioresorbable panel for interposition (interposition group). Postoperative complications and surgical outcomes of the 2 groups were compared. RESULTS Preoperative diplopia in both groups (n = 30) was resolved except 1 in interposition group after the reduction. Enophthalmos was resolved in 10 cases in the splint group and in 6 cases in the interposition group. In postoperative CT scans, 20 of the 57 cases in the splint group exhibited under- or overcorrection, compared with 9 of the 90 cases in the interposition group (P < 0.05). There were no sinus infections or implant-related side effects in the interposition group except for implant extrusion in 4 cases, whereas 7 cases developed sinusitis in the splint group (P < 0.05). CONCLUSIONS Endonasal endoscopic reduction using a bioresorbable panel may be considered as a surgical alternative for the treatment of medial orbital blowout fractures.
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Stability of Orbital Floor Fracture Fixation After Endoscope-Assisted Balloon Placement. J Craniofac Surg 2018; 28:e669-e672. [PMID: 28857988 DOI: 10.1097/scs.0000000000003826] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
In recent years, endoscope-assisted balloon fixation using transantral and endonasal approaches has gained popularity as a minimally invasive treatment for orbital floor fractures. However, the optimal duration for balloon placement and the efficacy of the method have not been fully evaluated. The authors report their assessment of this method using postoperative and chronological measurements of the maxillary sinus volume.Fourteen patients with blowout fracture of the orbital floor who underwent reduction using endoscopic transantral and endonasal approaches followed by 6-week fixation with a balloon were evaluated. The volume of the maxillary sinus was measured for comparison using computed tomography at the time of balloon removal and 6 months after the surgery.The ratio of change in the maxillary sinus volume (maxillary sinus volume 6 months after surgery/maxillary sinus volume at balloon removal) for all subjects was 0.90 to 1.04 (0.96 ± 0.44, mean ± SD). No postoperative reduction in volume was detected, indicating satisfactory fixation. Postoperative computed tomography showed bone regeneration in the orbital floor in all patients in whom the fractured bone fragments were removed. No subjects had remaining enophthalmos greater than 2 mm.The postoperative change in the maxillary sinus volume was small, confirming the efficacy of 6-week balloon placement. This method was effective even in patients in whom fractured bone fragments were removed. Therefore, it is advisable to remove the fractured bone fragments if there is concern that the fragments will stray into the orbit due to inflation of the balloon.
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Mishra GS, Bhatt SH. Eye Inside Out: Endonasal Endoscopic Reposition of Eye from Nose with Complete Vision Regainment. Craniomaxillofac Trauma Reconstr 2016; 10:84-88. [PMID: 28210414 DOI: 10.1055/s-0036-1584401] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2015] [Accepted: 12/27/2015] [Indexed: 10/21/2022] Open
Abstract
Faciomaxillary and ocular trauma is a common entity in most emergency and trauma units. We came across a 68-year-old female patient with a history of bull horn injury over the right eye. Examination revealed an empty orbital socket with unreliable perception of light present. Imaging showed that the eye had displaced posteroinferomedially to be lying in the ethmoid air cells in the nasal cavity. Under nasal endoscopic guidance, the eye was reposited back into the orbital socket and conjunctival sutures were taken to stabilize the position. The patient had vision of counting fingers at 1.5 m on the first postoperative day which improved to 6/24 on last follow-up. Such is the rarity that never before has such a case been described in literature where traumatic displacement of eyeball into the nose has been successfully repositioned by an endonasal endoscope with appreciable regaining of vision. It also further promotes endonasal endoscopic approach in the management of orbital blow out injuries.
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Affiliation(s)
- Girish S Mishra
- Department of Otorhinolaryngology, Head and Neck Surgery, Pramukh Swami Medical College and Shri Krishna Hospital, Anand, Gujarat, India
| | - Sushen Harish Bhatt
- Department of Otorhinolaryngology, Head and Neck Surgery, Pramukh Swami Medical College and Shri Krishna Hospital, Anand, Gujarat, India
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McMaster M, Caldwell F, Gillen A, Hespel A, Budny P, Abarca E. Reconstruction of a Complicated Orbital Depression Fracture with Medial Wall and Globe Repositioning in a Horse: A Collaboration Across Disciplines and Specialties. Vet Surg 2016; 45:529-35. [DOI: 10.1111/vsu.12477] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 07/03/2015] [Accepted: 10/04/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Mattie McMaster
- Department of Clinical Sciences, College of Veterinary Medicine; Auburn University; Auburn Alabama
| | - Fred Caldwell
- Department of Clinical Sciences, College of Veterinary Medicine; Auburn University; Auburn Alabama
| | - Alexandra Gillen
- Department of Clinical Sciences, College of Veterinary Medicine; Auburn University; Auburn Alabama
| | - Adrien Hespel
- Department of Clinical Sciences, College of Veterinary Medicine; Auburn University; Auburn Alabama
| | - Patrick Budny
- Plastic Surgery Associates of Montgomery; Montgomery Alabama
| | - Eva Abarca
- Department of Clinical Sciences, College of Veterinary Medicine; Auburn University; Auburn Alabama
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Sindwani R. Understanding the basic science and augmenting the clinical knowledge base of rhinologic disorders. Am J Rhinol Allergy 2015; 29:405-7. [PMID: 26637577 DOI: 10.2500/ajra.2015.29.4269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Abstract
The antral balloon technique is a useful procedure for the treatment of orbital fracture. Its advantages include being able to apply it without any donor-site morbidity. However, the saline injection catheter, which is inserted nasally from the natural ostium, sometimes causes discomfort. We present our new antral balloon technique with an implantable reservoir dome. This technique did not cause patient discomfort because no saline injection catheter was inserted nasally. It contributed to long-term placement of the antral balloon. Of 30 patients, satisfactory symmetries were achieved in 27 patients and the others required subsequent calvarial bone grafting for correction because of residual enophthalmos.
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Soejima K, Shimoda K, Kashimura T, Yamaki T, Kono T, Sakurai H, Nakazawa H. Endoscopic transmaxillary repair of orbital floor fractures: a minimally invasive treatment. J Plast Surg Hand Surg 2013; 47:368-73. [PMID: 23710787 DOI: 10.3109/2000656x.2013.769443] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Although endoscopic transmaxillary repair of orbital floor fractures is a minimally invasive treatment, controversy remains regarding the method for supporting the orbital floor after elevation of the orbital contents. To date, a urethral balloon catheter has been widely used. However, it can be difficult to leave the catheter in place for a long time period due to the inconvenience, and prolapse of the orbital contents may recur in the case of its premature removal. This study described the techniques for endoscopic reduction and use of a balloon for orbital floor fractures. From June 2006 through November 2011, 30 of 52 patients (57.7%) with an isolated orbital floor fracture underwent endoscopic transmaxillary repair. A maxillary sinus balloon (#3007, Koken Co., Japan) was inserted into the maxillary sinus to support the orbital floor after endoscopic transmaxillary reduction, and the connecting tube of the balloon was pulled into the nasal cavity through the maxillary ostium. After confirmation of accurate reduction by postoperative CT, the connecting tube was shortened and hidden in the nasal cavity. The balloon was left in place for 4-8 weeks, and then removed via the maxillary ostium on an outpatient basis. Complete resolution of the preoperative diplopia was achieved in 93%, and no late-developing enophthalmos was seen in 97% of the patients. There were no significant complications. This technique is safe and permits prolonged retention of the balloon, without interfering with daily life.
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Affiliation(s)
- Kazutaka Soejima
- Department of Plastic and Reconstructive Surgery, School of Medicine, Nihon University , Tokyo , Japan
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Wu W, Jing W, Selva D, Cannon PS, Tu Y, Chen B. Endoscopic Transcaruncular Repair of Large Medial Orbital Wall Fractures Near the Orbital Apex. Ophthalmology 2013; 120:404-9. [DOI: 10.1016/j.ophtha.2012.07.089] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Revised: 07/26/2012] [Accepted: 07/31/2012] [Indexed: 11/17/2022] Open
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Schultheiß S, Petridis AK, El Habony R, Maurer P, Scholz M. The transmaxillary endoscopic approach to the orbit. Acta Neurochir (Wien) 2013; 155:87-97. [PMID: 23129106 DOI: 10.1007/s00701-012-1525-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2012] [Accepted: 10/10/2012] [Indexed: 10/27/2022]
Abstract
OBJECTIVE In this surgical-anatomical cadaveric study we investigate the feasibility of the transmaxillary endoscopic approach to the intraorbital space. Anatomical landmarks are defined, the endoscopic view in the orbital space is studied and complications that can occur are discussed. METHODS Nine formalin-fixed heads were used to study the transmaxillary endoscopic approach to the orbit. The approach was used twice on each head (once for each maxilla). Therefore, we report our results on 18 transmaxillary intraorbital approaches. For better differentiation of anatomical structures, the veins and arteries were injected with blue and red plastic respectively in six cadaveric heads. RESULTS The transmaxillary approach enables viewing the inferior intraconal structures without endangering the infraorbital nerve and its artery and without diversion of the inferior rectus muscle. The optic nerve was visualised more easily through the approach medial to the inferior rectus muscle instead of lateral to the muscle since the ciliary nerves are in the way in the lateral approach. The combination of the approaches medial and lateral to the inferior rectus muscle allows very good identification of all important anatomical structures in the inferior intraconal space. CONCLUSION The transmaxillary endoscopic approach to the orbit is a useful new approach in the surgical armamentarium for orbital lesions. The overview of the inferior part of the orbit is excellent, and the lateral part of the optic nerve can be visualised. Careful anatomical dissection allows visualisation of important anatomical structures in the orbit without damaging nerves or arteries.
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Endoscopic reduction of medial orbital wall fractures using the rolled silastic sheet technique. ACTA ACUST UNITED AC 2009; 66:1421-4; discussion 1424. [PMID: 19430248 DOI: 10.1097/ta.0b013e31819db71b] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Endoscopic reduction has become common for reducing medial orbital wall fractures because of its various advantages. Nevertheless, there is no standard method of nasal packing to support the orbital contents to maintain the reduction. We evaluated the outcomes of endoscopic reduction of medial orbital wall fractures using the rolled Silastic sheet technique. METHODS Seventeen patients who underwent endoscopic reduction of medial orbital wall fractures were analyzed. They were diagnosed using 3-mm facial computed tomography and treated surgically under general anesthesia in our department between February 2006 and March 2008. Postoperatively, they were followed for at least 3 months. RESULTS The 17 patients comprised 13 men and 4 women ranging in age from 18 to 71 years (mean, 40.8 years). There were no significant intraoperative or postoperative complications. All 17 patients showed complete resolution of their symptoms after surgery. CONCLUSION The technique using the rolled Silastic sheet for medial orbital wall fractures supports the safety and efficacy of endoscopic reduction.
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Current world literature. Curr Opin Ophthalmol 2008; 19:435-43. [PMID: 18772678 DOI: 10.1097/icu.0b013e32830d5da2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Park YJ, Chung IY, Seo SW. An Analysis of Orbital Reconstruction with Bioresorbable Plate Through Orbital Volume Assessment. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2008. [DOI: 10.3341/jkos.2007.49.7.1046] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Affiliation(s)
- Yeon Jeong Park
- Department of Ophthalmology, Gyeongsang National University, Colleage of Medicine, Chinju, Korea
| | - In Young Chung
- Department of Ophthalmology, Gyeongsang National University, Colleage of Medicine, Chinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University, Chinju, Korea
| | - Seong Wook Seo
- Department of Ophthalmology, Gyeongsang National University, Colleage of Medicine, Chinju, Korea
- Gyeongsang Institute of Health Science, Gyeongsang National University, Chinju, Korea
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