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Jeong-min Hwang - One of the best experts on this subject based on the ideXlab platform.

  • Pediatric orbital wall fractures: Prognostic factors of diplopia and ocular motility limitation.
    PloS one, 2017
    Co-Authors: Yung Ju Yoo, Hee Kyung Yang, Namju Kim, Jeong-min Hwang
    Abstract:

    OBJECTIVES To investigate the factors affecting recovery of diplopia and limited ocular motility in pediatric patients who underwent surgery for orbital wall fracture. DESIGN Retrospective observational case series. METHODS In this retrospective observational case series, 150 pediatric patients (1-18 years old) who were diagnosed with orbital medial wall or floor fracture and underwent corrective surgery between 2004 and 2016 at Seoul National University Bundang Hospital were included. The medical records of patients with orbital medial wall or floor fracture were reviewed, including sex, age, diplopia, ocular motility, preoperative computed tomographic finding, and surgical outcomes. Factors affecting recovery of diplopia and ocular motility limitation were analyzed. RESULTS Of the 150 patients (134 boys; mean age, 14.4 years) who underwent corrective surgery for orbital wall fracture, preoperative binocular diplopia was found in 76 (50.7%) patients and limited ocular motility in 81 (54.0%). Presence of muscle incarceration or severe supraduction limitation delayed the recovery of diplopia. In case of ocular motility limitation, presence of muscle incarceration and Retrobulbar Hemorrhage were related with the delayed resolution. Multivariate analysis revealed supraduction limitation (Hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.19-2.55), larger horizontal orbital floor defects (HR = 1.22, 95% CI = 1.07-1.38), and shorter time interval to first visit (HR = 0.73) as negative prognostic factors for the recovery of diplopia. In addition, muscle incarceration (HR = 3.53, 95% CI = 1.54-8.07) and Retrobulbar Hemorrhage (HR = 3.77, 95% CI = 1.45-9.82) were found as negative prognostic factors for the recovery of motility limitation. CONCLUSIONS Presence of muscle incarceration and Retrobulbar Hemorrhage, horizontal length of floor fracture, supraduction limitation, and time interval from trauma to first visit were correlated with the surgical outcomes in pediatric orbital wall fracture patients. These results strengthen that the soft tissue damage associated with bony fracture affects the orbital functional unit. When managing children with orbital wall fracture, meticulous physical examination and thorough preoperative computed tomography based evaluation will help physicians to identify damage of orbital functional unit.

  • Kaplan-Meier curves of recovery of ocular motility limitation.
    2017
    Co-Authors: Yung Ju Yoo, Hee Kyung Yang, Namju Kim, Jeong-min Hwang
    Abstract:

    (A) Cumulative incidence of resolved ocular motility in pediatric patients with orbital wall fracture. The cumulative incidence of resolved ocular motility at 3 months was 50.0%. In 58 patients (76.3%), ocular motility was finally recovered. (B) Univariate analyses on risk factors for delayed ocular motility limitation. Patients with muscle incarceration experienced more delayed recovery than those without muscle incarceration. (C) Patients with Retrobulbar Hemorrhage experienced more late recovery than those without Retrobulbar Hemorrhage.

  • Pediatric orbital wall fractures: Prognostic factors of diplopia and ocular motility limitation.
    Public Library of Science (PLoS), 1
    Co-Authors: Yung Ju Yoo, Hee Kyung Yang, Namju Kim, Jeong-min Hwang
    Abstract:

    To investigate the factors affecting recovery of diplopia and limited ocular motility in pediatric patients who underwent surgery for orbital wall fracture.Retrospective observational case series.In this retrospective observational case series, 150 pediatric patients (1-18 years old) who were diagnosed with orbital medial wall or floor fracture and underwent corrective surgery between 2004 and 2016 at Seoul National University Bundang Hospital were included. The medical records of patients with orbital medial wall or floor fracture were reviewed, including sex, age, diplopia, ocular motility, preoperative computed tomographic finding, and surgical outcomes. Factors affecting recovery of diplopia and ocular motility limitation were analyzed.Of the 150 patients (134 boys; mean age, 14.4 years) who underwent corrective surgery for orbital wall fracture, preoperative binocular diplopia was found in 76 (50.7%) patients and limited ocular motility in 81 (54.0%). Presence of muscle incarceration or severe supraduction limitation delayed the recovery of diplopia. In case of ocular motility limitation, presence of muscle incarceration and Retrobulbar Hemorrhage were related with the delayed resolution. Multivariate analysis revealed supraduction limitation (Hazard ratio [HR] = 1.74, 95% confidence interval [CI] = 1.19-2.55), larger horizontal orbital floor defects (HR = 1.22, 95% CI = 1.07-1.38), and shorter time interval to first visit (HR = 0.73) as negative prognostic factors for the recovery of diplopia. In addition, muscle incarceration (HR = 3.53, 95% CI = 1.54-8.07) and Retrobulbar Hemorrhage (HR = 3.77, 95% CI = 1.45-9.82) were found as negative prognostic factors for the recovery of motility limitation.Presence of muscle incarceration and Retrobulbar Hemorrhage, horizontal length of floor fracture, supraduction limitation, and time interval from trauma to first visit were correlated with the surgical outcomes in pediatric orbital wall fracture patients. These results strengthen that the soft tissue damage associated with bony fracture affects the orbital functional unit. When managing children with orbital wall fracture, meticulous physical examination and thorough preoperative computed tomography based evaluation will help physicians to identify damage of orbital functional unit

Sajid Ataullah - One of the best experts on this subject based on the ideXlab platform.

Richard M. Best - One of the best experts on this subject based on the ideXlab platform.

Babak Masomian - One of the best experts on this subject based on the ideXlab platform.

  • Retrobulbar Hemorrhage after Blowout Fracture Reconstruction: A Case Report
    Iranian Journal of Ophthalmology, 2011
    Co-Authors: Bahram Eshraghi, Alireza Keshtcar Jafari, Babak Masomian
    Abstract:

    Purpose: To report a case of total blindness a few hours after orbital blowout fracture repair; the visual acuity (VA) returned to normal after immediate reoperation. Case report: A 21-year-old man with obvious enophthalmos in the left side, 2 weeks after car accident, was candidate for orbital floor reconstruction surgery. Anterior orbitotomy from subcilliary incision was done and at the end of the surgery, titanium medpore inserted in orbital floor. Three hours after surgery patient complained of severe pain and a significant proptosis was noticed. VA was no light perception (NLP) and relative afferent pupillary defect (RAPD) was positive. The patient reoperated and medpore plate was removed. There was significant blood in orbital cavity that was totally removed. Three hours after reoperation proptosis disappeared and VA improved to 3M count finger. One week after the surgery the VA was raised to 20 /20. Conclusion: Acute severe pain in the early postoperative period, may be a sign of the orbital Hemorrhage. Awareness of the potential severity of this complication and execution of appropriate treatment with minimal delay, may result in rapid and complete visual recovery.

Robert M. Kershner - One of the best experts on this subject based on the ideXlab platform.