No abstract available.
Optic Nerve Injuries* ; Orbit*

The medial wall and floor of the bony orbit are frequently fractured because of the delicate anatomy. To optimize functional and aesthetic results, reconstructive surgeons should understand the anatomy and pathophysiology of orbital fractures. Appropriate treatment involves optimal timing of intervention, proper indications for operative repair, incision and dissection, release of herniated tissue, implant material and placement, and wound closure. The following review will discuss the management of orbital floor fractures, with the operative method preferred by the author. Special considerations in operation technique and the complication are also present in this article.
Methods ; Orbit* ; Orbital Fractures ; Surgeons ; Wounds and Injuries

Growing skull fracture is a rare complication of a closed head injury during infancy and childhood. Most growing skull fracture are located in the parietal region. The authors report a case of growing skull fracture of the orbital roof using three dimentional computerized tomography(3-D CT) imaging, the shpae and the size of defect were clearly demonstrated.
Head Injuries, Closed ; Orbit* ; Rabeprazole ; Skull Fractures* ; Skull*

We compared the result of 6 patients[group A]treated with high dose steroid only with the result of 14 patients[group B]treated with optic canal decompression after at least 24 hours of high dose steroid therapy without improvement. 4 of 6 patients[66%]in group A and 7 of 14 patients[50%]in group B improved in visual acuity.But 1 of 6 patients[17%] in group A and 6 of 14 patients[43%]in group B had marked improvement in visual function[above 0.02].Of 5 patients with optic canal fracture in orbit CT in group B, all had improved visual function and 4 had marked improvement in visual function. If CT demonstrates bony fragments impinging on intracanalicular optic nerve, or if vision deteriorates or fails to improve during the first 24 hours of high dose steroid and initial visual acuity is no light perception, optic canal decompression is considered effective and valid treatment modality in TON.
Decompression* ; Humans ; Optic Nerve ; Optic Nerve Injuries* ; Orbit ; Visual Acuity

Orbital emphysema is a recognized complication of various kinds of orbital and facial injury. It is usually benign and transient but can potentially elicit serious visual complications. Its significance as a threat to sight and its diagnostic value have been underestimated in the field of otolaryngology. Recently, we experienced an unusual case of orbital emphysema following nose blowing. A reliable past history and physical examination showed no direct trauma to the orbit. We report this case with a review of its pathophysiology, diagnosis and adequate management through the literature.
Diagnosis ; Emphysema* ; Facial Injuries ; Nose ; Orbit* ; Otolaryngology ; Physical Examination

Humans ; Neck/surgery* ; Orbit/injuries* ; Thorax ; Wounds, Penetrating

Adult ; Head Injuries, Penetrating ; diagnostic imaging ; etiology ; surgery ; Humans ; Male ; Orbit ; injuries ; Tomography, X-Ray Computed

BACKGROUND AND OBJECTIVES: Traumatic optic neuropathy (TON) is a relatively rare complication associated with closed head injury. However, it represents an extremely poor prognosis, and its management remains controversial. We present the treatment results of 15 patients with immediate and complete TON who were treated with megadose steroids (MDS), and, in cases where MDS produced no response, intranasal optic nerve decompression (OND). PATIENTS AND METHODS: The diagnosis of TON was based on evidence of the following : complete loss of vision, absence of direct pupillary light reflex and intact consensual response. All of the patients underwent high resolution CT scans of the orbit and received a complete neuro-opthalmologic examination. MDS was started immediately after the diagnosis. If no response occurred by 48 hours, an intranasal OND was conducted. RESULTS: Two of the 15 patients exhibited improved vision after treatment with MDS, and six of the remaining 13 patients who were unresponsive to MDS demonstrated improved vision after OND. Overall, eight out of the 15 patients experienced improved vision. CONCLUSION: This study is uncontrolled, but suggests that our protocol of MDS and, in cases where this produced no response, OND may be an effective and valid treatment modality for patients with immediate complete TON, which is generally believed to represent an extremely poor prognosis regardless of treatment.
Decompression* ; Diagnosis ; Head Injuries, Closed ; Humans ; Optic Nerve Injuries* ; Optic Nerve* ; Orbit ; Prognosis ; Reflex ; Steroids* ; Tomography, X-Ray Computed

The midface are bounded by a line connecting the two zygomaticofrontal suture, passing through the frontomaxillary and frontonasal suture, and limited below by the occlusal plane of maxillary teeth. Midface fractures include fractures affecting the maxilla, the zygoma, and the nasoorbital ethmoid complex. Midface fractures can be classified as LeFort 1, II, III fractures, sygomaticomaxillary complex fractures, zygomatic arch frationctures, or nasoorbital ethmoid fractures. These injuries may be isolated or occur in combine. And sort tissue injuries to the facial structures are commonly encountered in the treatment of midface fractured patient. Soft tissue wounds may be limited to the superficial structures, but more serious injuries may extend to involve anatomic structures such as the sensory and motor nerves of the face; the parotid, or nasolacrimal glands or ducts ; or the dentoalveolar structures. Especially, these fractures are combined with the orbit, brain injuries and skull base fractures. This is to report the incidence, causes, criteria, complication and treatments of patients who visited our department for midface fracture, for last 10 years.
Brain Injuries ; Dental Occlusion ; Humans ; Incidence ; Maxilla ; Orbit ; Skull Base ; Sutures ; Tooth ; Wounds and Injuries ; Zygoma ; Zygomatic Fractures

Utile recently, osteotomy & reposition surgery of prominent zygoma have been performed by means of a coronal incision or intraoral preauricular incision. But penalties are paid, such as scar, the possibility of facial nerve injury and long operative time. Reflecting on our past experiences of facial bone surgery, we developed an alternative approach. In our method, the protrusion in the cheekbone is corrected by performing an osteotomy and reposition method through intraoral incision only. During the past 3 years we have operated on 23 patients of malar prominences. The amount of the bone to be removed is determined on preoperative interview, physical examination and x-rays. Intraoral incision provide access to the zygomatic body and lateral orbital rim. After L-shaped osteotomy, two paralle vertical and one transverse osteotomies, at medical part of the zygomatic body, the midsegment is removed. Posterior portion of zygomatic arch was approached through medical aspect and was outfractured using curved osteotome. After completion of triple osteotomy, the movable zygomatic complex was reduced medially and fixed with miniplates and screws on the zygomaticomaxillary buttress. The patients were followed for 9.5 months with acceptable result and little complication. The author concludes that this technique is effective and safe method in reduction malarpalsty.
Cicatrix ; Facial Bones ; Facial Nerve Injuries ; Humans ; Operative Time ; Orbit ; Osteotomy ; Physical Examination ; Zygoma