Blow out fractures occur in many patients who suffer from blunt trauma in the face. The typical signs and symptoms are diplopia, limited eye movement and enophthalmos. Upper eyelid ptosis is a relatively rare symptom caused by blowout fracture, where traumatic ptosis accounts for only 1-9%. The etiology is usually the result of a direct levator muscle injury due to eyelid trauma. Sometimes traumatic blepharoptosis occurs due to ischemic damage to the superior branch of the oculomotor nerve. Generally, blepharoptosis caused by blow out fracture is treated with conservative treatment unless there is some evidence of bone impingement. The authors report one case of blepharoptosis caused by blow out fracture, which was treated successfully.
Blepharoptosis ; Diplopia ; Enophthalmos ; Eye Movements ; Eyelids ; Humans ; Muscles ; Oculomotor Nerve ; Orbit ; Orbital Fractures

The orbital wall is commonly fractured and its incidence ranges from 18 to 50% of all craniofacial fractures.1,2) Numerous papers have been reported about the surgical indication, surgical timing, approach options, and reconstruction materials for orbital blowout fractures. However, there are still debates on the ideal surgical options. The choice of surgical approach and materials for reduction of orbital blowout fractures depends on the surgeon's experience and preference. Recently, use of endoscope for blowout fractures has been popular worldwide due to its advantages over open reduction surgeries. In this review, I will discuss new techniques and concepts of the treatment of orbital blowout fractures with particular references.
Endoscopes ; Incidence ; Orbit

We present a very rare case of a 29-month-old boy with acute onset right abducens nerve palsy complicated by inferior petrosal sinus septic thrombosis due to mastoiditis without petrous apicitis. Four months after mastoidectomy, the patient fully recovered from an esotropia of 30 prism diopters and an abduction limitation (-4) in his right eye.
Abducens Nerve Diseases/diagnosis/*etiology ; Child, Preschool ; Diagnosis, Differential ; Humans ; Male ; Mastoiditis/*complications/diagnosis/surgery ; Otitis Media/*complications/diagnosis ; Sinus Thrombosis, Intracranial/*complications/diagnosis

Foreign bodies in the maxillary sinus are rare and mostly of traumatic origin. These foreign bodies result in pain, bleeding and infection and are immediately removed in most cases. Sometimes the foreign body without serious symptoms can remain for several years without treatment. However, the prognosis of foreign bodies in the paranasal sinuses can be severe. Therefore, regardless of the symptoms present, it seems worthwhile to remove the foreign body from the paranasal sinuses in order to prevent any possibility of further complications. The authors report a case of foreign body occurring in maxilla and maxillary sinus without symptoms for 25 years with related literatures.
Foreign Bodies ; Hemorrhage ; Maxilla ; Maxillary Sinus ; Paranasal Sinuses ; Prognosis

Enophthalmos means displacement of the globe into the bony orbit backward, and usually downward. In post-traumatic enophthalmos, the mechanisms that determine the globe position can be the enlargement of the orbital cavity, the herniation of orbital fat into the maxillary sinus, fat atrophy, loss of ligament support, and scar contracture. It can be reconstructed through several approaches such as transconjunctival, canthotomy, lower eye lid, coronal approach, and by using bone, cartilage, and alloplastic materials. The authors report a case of postoperative enophthalmos reconstructed through subciliary and transnasal endoscopic approaches using porous polyethylene with embedded titanium.
Atrophy ; Cartilage ; Cicatrix ; Contracture ; Displacement (Psychology) ; Endoscopes ; Enophthalmos ; Eye ; Humans ; Ligaments ; Maxillary Sinus ; Orbit ; Polyethylene ; Polyethylenes ; Titanium

Ocular symptoms related to orbital fracture occur immediately after the fracture in most cases. However, authors experienced a delayed onset diplopia occurred 16 months after orbital floor fracture. A 19-year-old man, who had right orbital floor fracture 16 months ago, presented with diplopia of upward gaze. At the time of the fracture, no surgery was performed because the fracture was minimal and there were no particular symptoms. Physical examinations revealed a minor ocular motility restriction of upward gaze, but orbital floor showed no definite interval change on computed tomography. Severe adhesion between the orbital fat tissue and orbital floor was noted intraoperatively and the adhesion was dissected. After the operation, the patient showed remarkable improvement in diplopia and restriction of the ocular motility.
Diplopia ; Floors and Floorcoverings ; Humans ; Orbit ; Orbital Fractures ; Physical Examination ; Young Adult

Traumatic optic neuropathy is a complication resulting from facial trauma, with an incidence of 2% to 5%. The most widely accepted treatments include observation, high dose steroid, surgical decompression and combination therapy of steroid and surgical treatment. However, there has been no established mode of treatment and there are still debates about what the best treatment should be for the patients with optic canal fracture. We experienced two cases of traumatic optic neuropathies due to intracanalicular fracture of the optic canal after trauma. Surgical decompression was performed using an endoscope int-ranasally one day after injury as required for minimal invasive surgery. We report the results and progression of these two cases.
Decompression ; Decompression, Surgical ; Endoscopes ; Humans ; Incidence ; Optic Nerve ; Optic Nerve Injuries

Background and Objectives: Chronic rhinosinusitis with nasal polyposis (CRSwNP) is one phenotype of the diffuse type. In spite of surgical and medical treatment, the polyp recurrence rate is high. Recently biologics are concerned as a therapeutic option of it. To figure out adverse events associated with the dupilumab injection in adult patients with CRSwNP.Subjects and Method Retrospective chart review of patients that were treated with dupilumab from January 2022 to December 2022 for CRSwNP was performed. Results: Of 40 patients (23 of male and 17 of female), 8 patients (20.0%) experienced 9 patients (22.5%) adverse events. The most common adverse event was skin reaction (3 patients, 7.5%), followed by 2 of pruritis, 2 of epistaxis. Three patients quit dupilumab after the adverse events, 4 patients continued, and 1 patient hold the next injection. Conclusion Dupilumab is reported to be relatively safe medication. However, physician should notice that adverse events including skin rash can occur after dupilumab injection.

BACKGROUND AND PURPOSE: Many previous studies have investigated forward gait (FG), backward gait (BG), and dual-task gait (DG) in patients with Parkinson's disease (PD). However, it remains uncertain whether gait parameters are implicated in motor symptoms or the risk of falling, especially in patients with de novo PD. METHODS: Demographic and clinical characteristics including the Fear of Falling Measure (FFM) were assessed in patients with de novo PD and in healthy subjects. A computerized gait analysis using the GAITRite system was performed for FG, BG, and DG. The Unified Parkinson's Disease Rating Scale Part III was assessed in patients with PD. RESULTS: This prospective study included 24 patients with de novo PD and 27 controls. Compared with controls, patients with de novo PD showed a slower gait and shorter stride in all three gaits. Patients with de novo PD also exhibited increases in the stride-to-stride variability in the stride time and stride length of the gait for BG, increased length for DG, and no increase for FG. Moreover, the BG speed in de novo PD patients was significantly associated with their motor symptoms (bradykinesia, postural instability, gait difficulty, and total motor score) and negatively correlated with the FFM score. CONCLUSIONS: The BG dynamics were more impaired and more closely related to motor symptoms and fear of falling than were the FG or DG dynamics in patients with de novo PD, indicating that BG parameters are potential biomarkers for the progression of PD.
Accidental Falls ; Biomarkers ; Gait ; Healthy Volunteers ; Humans ; Parkinson Disease ; Prospective Studies