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Michael J Yaremchuk - One of the best experts on this subject based on the ideXlab platform.
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reply quantitative assessment of medial Orbit Fracture repair using computer designed anatomical plates
Plastic and Reconstructive Surgery, 2012Co-Authors: Chad R Gordon, Srinivas M Susarla, Michael J YaremchukAbstract:BACKGROUND The purpose of this study was to objectively assess the accuracy of Orbital reconstruction in patients with medial wall Fractures following placement of computer-designed, prebent anatomical mesh plates by means of a transconjunctival-retrocaruncular approach. METHODS This was a retrospective, cohort study of consecutive subjects with facial trauma who underwent reconstruction of medial wall/Orbital floor defects over a 12-month period at a level I trauma center. All subjects had preoperative and postoperative computed tomographic scans with 1.25-mm slices formatted in the axial, coronal, and sagittal planes with a minimum of 3 months' follow-up. Preoperative and postoperative Orbital volumes were computed using integrated analysis over the Orbital slices. The volumes were compared using nonparametric paired samples comparisons (Wilcoxon signed ranks test). For all analyses, p ≤ 0.05 was considered significant. RESULTS Fifteen subjects underwent repair of 17 medial wall Fractures. The mean patient age was 37 ± 16 years (range, 18 to 59 years); one subject was female. Motor vehicle-related incidents and assaults were the most common mechanisms of injury. The average postoperative volume for the Fractured sides was 22. 2 ± 2.1 cm3 (range, 19.9 to 26.9 cm3) and was statistically significantly lower than the preoperative volume on the Fractured side (24.18 ± 2.57 cm3; p < 0.001). One patient (6.7 percent) experienced a postoperative complication requiring reoperation. CONCLUSION Computer-designed, prebent anatomical mesh plates placed using a transconjunctival-retrocaruncular approach for reconstruction of medial wall Fractures with Orbital floor components reliably results in restoration of contour and volume, with a low complication rate. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Chad R Gordon - One of the best experts on this subject based on the ideXlab platform.
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reply quantitative assessment of medial Orbit Fracture repair using computer designed anatomical plates
Plastic and Reconstructive Surgery, 2012Co-Authors: Chad R Gordon, Srinivas M Susarla, Michael J YaremchukAbstract:BACKGROUND The purpose of this study was to objectively assess the accuracy of Orbital reconstruction in patients with medial wall Fractures following placement of computer-designed, prebent anatomical mesh plates by means of a transconjunctival-retrocaruncular approach. METHODS This was a retrospective, cohort study of consecutive subjects with facial trauma who underwent reconstruction of medial wall/Orbital floor defects over a 12-month period at a level I trauma center. All subjects had preoperative and postoperative computed tomographic scans with 1.25-mm slices formatted in the axial, coronal, and sagittal planes with a minimum of 3 months' follow-up. Preoperative and postoperative Orbital volumes were computed using integrated analysis over the Orbital slices. The volumes were compared using nonparametric paired samples comparisons (Wilcoxon signed ranks test). For all analyses, p ≤ 0.05 was considered significant. RESULTS Fifteen subjects underwent repair of 17 medial wall Fractures. The mean patient age was 37 ± 16 years (range, 18 to 59 years); one subject was female. Motor vehicle-related incidents and assaults were the most common mechanisms of injury. The average postoperative volume for the Fractured sides was 22. 2 ± 2.1 cm3 (range, 19.9 to 26.9 cm3) and was statistically significantly lower than the preoperative volume on the Fractured side (24.18 ± 2.57 cm3; p < 0.001). One patient (6.7 percent) experienced a postoperative complication requiring reoperation. CONCLUSION Computer-designed, prebent anatomical mesh plates placed using a transconjunctival-retrocaruncular approach for reconstruction of medial wall Fractures with Orbital floor components reliably results in restoration of contour and volume, with a low complication rate. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Srinivas M Susarla - One of the best experts on this subject based on the ideXlab platform.
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reply quantitative assessment of medial Orbit Fracture repair using computer designed anatomical plates
Plastic and Reconstructive Surgery, 2012Co-Authors: Chad R Gordon, Srinivas M Susarla, Michael J YaremchukAbstract:BACKGROUND The purpose of this study was to objectively assess the accuracy of Orbital reconstruction in patients with medial wall Fractures following placement of computer-designed, prebent anatomical mesh plates by means of a transconjunctival-retrocaruncular approach. METHODS This was a retrospective, cohort study of consecutive subjects with facial trauma who underwent reconstruction of medial wall/Orbital floor defects over a 12-month period at a level I trauma center. All subjects had preoperative and postoperative computed tomographic scans with 1.25-mm slices formatted in the axial, coronal, and sagittal planes with a minimum of 3 months' follow-up. Preoperative and postoperative Orbital volumes were computed using integrated analysis over the Orbital slices. The volumes were compared using nonparametric paired samples comparisons (Wilcoxon signed ranks test). For all analyses, p ≤ 0.05 was considered significant. RESULTS Fifteen subjects underwent repair of 17 medial wall Fractures. The mean patient age was 37 ± 16 years (range, 18 to 59 years); one subject was female. Motor vehicle-related incidents and assaults were the most common mechanisms of injury. The average postoperative volume for the Fractured sides was 22. 2 ± 2.1 cm3 (range, 19.9 to 26.9 cm3) and was statistically significantly lower than the preoperative volume on the Fractured side (24.18 ± 2.57 cm3; p < 0.001). One patient (6.7 percent) experienced a postoperative complication requiring reoperation. CONCLUSION Computer-designed, prebent anatomical mesh plates placed using a transconjunctival-retrocaruncular approach for reconstruction of medial wall Fractures with Orbital floor components reliably results in restoration of contour and volume, with a low complication rate. CLINICAL QUESTION/LEVEL OF EVIDENCE Therapeutic, IV.
Myeonggon Jeon - One of the best experts on this subject based on the ideXlab platform.
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clinical analysis of blow in Orbit Fracture and its treatment
Archives of Plastic Surgery, 2004Co-Authors: Geonyong Seong, Myeonggon JeonAbstract:Blow-in Orbit Fracture is relatively rare Fracture which is an inward displacement of the Orbital rim or wall fragment, resulting in decreased Orbital volume. The objective of this article is to analyze blow-in Fracture status of Orbit and to suggest appropriate management in this unusual Fracture. The study included 23 cases who had treatment of blow-in Fractures of Orbit from July, 1995 to June, 2001. Their ages ranged from 4 years to 63 years. There were 17 males and 6 females. The diagnosis of blow-in Fracture was accomplished with physical examination, ophthalmologic examination, plain X-ray, and facial CT scan. According to Antonyshyn's classification, we classified them into 2 large groups which were pure type and impure type. Pure type blow-in Fractures are relatively uncommon and 5 cases were documented in a series of 23 patients. Impure type Fractures included the Orbital rim and 18 cases were documented. Clinical symptoms of blow-in Fractures were proptosis, limitation of eyeball movement, diplopia, blepharoptosis, subconjunctival hemorrage and blindness. 2 patients with globe rupture and blindness underwent enucleation due to direct injury by bony segment. We conclude that early and appropriate surgical treatment with complete examination is very important to prevent blepharoptosis, proptosis, limitation of eyeball movement and optic nerve compression. However, when globe rupture and blindness by direct injury of bony segment happened, the operation of enucleation was needed in this particular case.
Joseph S Gruss - One of the best experts on this subject based on the ideXlab platform.
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trapdoor Fracture of the Orbit in a pediatric population
Plastic and Reconstructive Surgery, 2002Co-Authors: John H Grant, James R Patrinely, Avery Weiss, Philip C Kierney, Joseph S GrussAbstract:Orbital-floor blowout Fractures of the trapdoor variety, first described by Soll and Poley, have also appeared in the French and Japanese literature. The trapdoor Fracture is described as a pure Orbital-floor Fracture, linear in form and hinged medially, which allows herniation of Orbital contents through the Fracture and then entraps these herniated contents. A review of the Orbital-floor Fracture literature reveals a high incidence of persistent diplopia associated with ocular-muscle entrapment, which may later necessitate corrective surgery of extraocular muscles. Recent publications in the ophthalmologic literature have stressed the importance of early surgical intervention. This article reports a retrospective series of 19 pediatric patients (age range, 5 to 16 years) who presented to two institutions. All patients had radiographic confirmation of a trapdoor Fracture. Physical examination demonstrated a high association between these Fractures and restricted ocular motility (17 of the 19 patients). In the cases with trapdoor Fracture and restricted ocular movement, early intervention was associated with better postoperative function. It is thus recommended that the symptomatic trapdoor Orbit Fracture be considered an urgent indication for surgical intervention. Practitioners therefore must have a high index of suspicion for these injuries. Prompt diagnosis is critical to maximize clinical outcome.
