1.Patient-Specific Implant for Primary Orbital Reconstruction: A Case Report
Ting Jennifer ; Mohd Ferdaus Isa ; Jothi Raamahlingam Rajaran ; Abd Jabar Nazimi
Archives of Orofacial Sciences 2022;17(2):259-267
ABSTRACT
The main aim of orbital fracture reconstruction is to restore the functional and aesthetic components
of the eye. However, it is known that surgery for complex three-dimensional anatomy of the orbit is
always a challenge. With recent advancements in technology, surgical predictability and outcomes have
greatly improved. Several methods for orbital reconstruction surgery have been documented such as
virtual surgical planning, intraoperative navigation, intraoperative imaging, and the use of patient-specific
implant (PSI). PSI made of titanium can be designed by using a computer-aided design process and
manufacturing (CAD-CAM) of CT-scan routinely used during diagnostic imaging. With precise analyses
in shape and size followed by personalised implant design, the surgical precision can be alleviated
further and at the same time, the surgical duration could be reduced with anticipation of better surgical
outcomes. However, meticulous planning needs to be done preoperatively, with the timing of the surgery
being an important factor. In the present case, pure orbital blowout fracture primarily treated with a
personalised-implant solution derived from 3D-printing technology is described. Both pre-surgical and
surgical workflow of this computer-assisted surgical method is elaborated. PSI for primary orbital
reconstruction can be regarded as a viable alternative surgical solution including its working timeframe
and adherence to the surgical protocol or algorithm.
Orbital Fractures--surgery
;
Orbital Implants
2.Measurement Analytical Study of Computed Tomography of the Orbital Structure in Acute Blow-out Fracture.
Seong Ho JEONG ; Seung Han SHIN ; Seung Ha PARK ; Sang Hwan KOO
Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(1):44-51
PURPOSE: Blow-out fracture is one of the most common fractures in facial trauma. It is diagnosed by Computed Tomography(CT) scan, which is considered as the most effective diagnostic tool. Since, the Picture Archiving Communication System(PACS) has been provided recently to many hospitals, doctors are more familiar with imaging software of PACS. Because this software has many useful measuring tools, doctors can measure orbital structure easily and make a plan for treatment with its data. Therefore, authors intended to analyze the data of orbital structure measured with PACS imaging software and evaluate its usefulness. METHODS: The charts and CT images of 100 patients, which were 50 patients with medial wall fracture and 50 patients with floor fracture, were reviewed. Patients were selected by pre-determined criteria and their CT images were measured with image software of PACS. 'Extraocular muscle thickness', 'Defect ratio'(ratio of defect area to normal area) and 'Globe position index' were measured and analyzed statistically. RESULTS: The thickness of inferior rectus muscle and medial rectus muscle was simultaneously increased in acute-stage of blow-out fracture. The medial rectus muscle was more thickened in medial wall fracture and inferior rectus was more thickened in floor fracture, respectively. In acute blow-out fracture, globe position is exophthalmic rather than enophthalmic. Especially in floor fracture, numerical value summed up thickness of all extraocular muscle is correlated to the defect ratio and globe position index. CONCLUSION: Clinicians can decide globe position or presume defect ratio in inferior wall fracture by measurement of CT image in acute blow-out fracture using PACS.
Humans
;
Orbit*
;
Orbital Fractures*
3.Measurement Analytical Study of Computed Tomography of the Orbital Structure in Acute Blow-out Fracture.
Seong Ho JEONG ; Seung Han SHIN ; Seung Ha PARK ; Sang Hwan KOO
Journal of the Korean Society of Plastic and Reconstructive Surgeons 2007;34(1):44-51
PURPOSE: Blow-out fracture is one of the most common fractures in facial trauma. It is diagnosed by Computed Tomography(CT) scan, which is considered as the most effective diagnostic tool. Since, the Picture Archiving Communication System(PACS) has been provided recently to many hospitals, doctors are more familiar with imaging software of PACS. Because this software has many useful measuring tools, doctors can measure orbital structure easily and make a plan for treatment with its data. Therefore, authors intended to analyze the data of orbital structure measured with PACS imaging software and evaluate its usefulness. METHODS: The charts and CT images of 100 patients, which were 50 patients with medial wall fracture and 50 patients with floor fracture, were reviewed. Patients were selected by pre-determined criteria and their CT images were measured with image software of PACS. 'Extraocular muscle thickness', 'Defect ratio'(ratio of defect area to normal area) and 'Globe position index' were measured and analyzed statistically. RESULTS: The thickness of inferior rectus muscle and medial rectus muscle was simultaneously increased in acute-stage of blow-out fracture. The medial rectus muscle was more thickened in medial wall fracture and inferior rectus was more thickened in floor fracture, respectively. In acute blow-out fracture, globe position is exophthalmic rather than enophthalmic. Especially in floor fracture, numerical value summed up thickness of all extraocular muscle is correlated to the defect ratio and globe position index. CONCLUSION: Clinicians can decide globe position or presume defect ratio in inferior wall fracture by measurement of CT image in acute blow-out fracture using PACS.
Humans
;
Orbit*
;
Orbital Fractures*
4.A clinical study of orbital fractures.
Seung Dae PAEK ; Yo Wan KIM ; Deug Rok CHOI ; Jong Gon KIM ; Seong Ho CHUN
Korean Journal of Otolaryngology - Head and Neck Surgery 1993;36(6):1230-1236
No abstract available.
Orbit*
;
Orbital Fractures*
5.Management of true blow-out fractures of the orbital floor by transplant of anterior wall of the maxillary sinus.
Jae Hwy LEE ; Jung Soo BAE ; Dong Soo JANG
Journal of the Korean Association of Oral and Maxillofacial Surgeons 1993;19(3):389-399
No abstract available.
Maxillary Sinus*
;
Orbit*
;
Orbital Fractures*
6.Comparison of Diplopia and Ocular Torsion Rate in Blow-Out Fracture Patients.
Kyoung Lae KIM ; Sung Pyo PARK ; Hyoung Kyun KIM
Journal of the Korean Ophthalmological Society 2015;56(2):162-167
PURPOSE: We compared ocular torsion rates in blow-out fracture patients before and after blowout fracture repair by analyzing mean disc foveal angles. METHODS: The study participants were divided into 2 groups: blow-out fracutre repair patients (n = 36) and controls (n = 36). We measured ocular torsion rates by analyzing mean disc foveal angle. The angle was composed of 2 imaginary horizontal lines which crossed the optic disc center and fovea. We compared statistically ocular torsion rates in blow-out fracture patients based on subsided diplopia, continued diplopia, or absence of diplopia before and after blow-out fracture repair using paired t-test. RESULTS: In the patient group, ocular torsion rates were statistically significantly decreased. In the blow-out fracture repair group with subsided diplopia, ocular torsion rates were decreased statistically from 7.74 +/- 3.48 degrees before blow-out fracture repair to 5.02 +/- 3.11 degrees after blow-out fracture repair. In the blow-out fracture repair group with continued diplopia or absence of diplopia before surgery, ocular torsion rates did not change statistically significantly from 6.36 +/- 2.80 degrees before blow-out fracture repair to 6.51 +/- 3.24 degrees after blow-out fracture repair. CONCLUSIONS: Subsided diplopia after blow-out fracture repair and ocular torsion rate changes were significantly related in blow-out fracture patients. Further research which on the correlation of intraorbital change and movement of orbital position after blow-out fracture repair with ocular torsion rates are necessary.
Diplopia*
;
Humans
;
Orbit
;
Orbital Fractures*
7.Pulsatile Ocular Blood Flow Measurements in Ocular Trauma Patients.
Helen LEW ; Seok Ho BYUN ; Sang Yeul LEE
Journal of the Korean Ophthalmological Society 2000;41(1):244-250
The objective of this study was to ascertain the elationship between the various ocular traumas and the change of pulsatile ocular blood flow[POBF] measured with Ocular Blood Flow Tonograph[OBF Laboratories, UK Ltd.]. We tested POBF with Ocular Blood Flow Tonograph 3 times repeatedly within 48 hours after trauma in the 33 ocular trauma patients.In all the trauma eyes, heart rate[HR]and intraocular pressure[IOP]were higher and pulse amplitude [PA], pulse volume[PV], POBF were lower than in all the fellow eyes.In the hyphema group, HR, IOP, PA, PV, POBF were higher, especially IOP and OBF%S.D.were statically significant, than in non-hyphema group.In the orbital fracture group, only POBF and OBF%S.D.were higher than those of in non-fracture group. Therefore, these results show the change of POBF after various ocularinjuries in the ocular trauma patients.The further studies to follow up the serial change of POBF are necessary.
Heart
;
Humans
;
Hyphema
;
Orbital Fractures
8.Usefulness of Two-dimensioanl CT & Three-dimensional CT in Blow-out Fracture.
Tae Soo BAN ; Kyoung Soo NA ; Nam Cheol JI
Journal of the Korean Ophthalmological Society 1999;40(3):639-645
The purpose of this study is to compare the diagnostic accuracy and usefulness of three-dimensional CT, two-dimensional CT in case of blow-out fracture. Two-dimensional CT, three-dimensional CT images of twenty-four blow-out fracture and soft tissue incarceration. Two dimensional CT was superior to three-dimensional CT in evaluating orbital bone fracture and soft tissue incarceration. But, three-dimensional CT was more useful to identify of orbital bone fracture than two-dimensional CT in associated facial bone fracture. Coexamination with two-dimensional axial & three-dimensonal CT was useful not only in the detection of fracture but in the evaluation of soft tissue incarcerated blow-out fracture.
Facial Bones
;
Fractures, Bone
;
Orbit
;
Orbital Fractures*
9.Correction of Posttraumatic Enophthalmos.
Ron HAZANI ; Michael J YAREMCHUK
Archives of Plastic Surgery 2012;39(1):11-17
Management of posttraumatic enophthalmos can present as a challenge to the reconstructive surgeon, particularly in cases of late presentation. This article reviews the pertinent anatomy of the orbit, diagnostic modalities, indications for surgery, and surgical approaches as they relate to the treatment of posttraumatic enophthalmos. Internal orbital reconstruction has evolved to an elegant procedure incorporating various biologic or alloplastic implants, including anatomical pre-bent implants. Successful repair of late enophthalmos has been demonstrated in multiple recent studies and is likely related to the precision with which orbital anatomy can be restored.
Enophthalmos
;
Orbit
;
Orbital Fractures
;
Orbital Implants
;
Polymethacrylic Acids
10.Blow-out Fracture, Cyanoacrylate Fixation and Clinical Aspects of 27 Patients.
Journal of the Korean Ophthalmological Society 1991;32(7):514-519
Blow-out fracture is a fracture of the weadk bony orbital floor resulting from the transmission of intraorbital pressure in a blunt trauma. In this report, I analyse the clinical aspects of 27 patients who were treated with cyanoacrylate during open reduction. The leading cause was a traffic accident(17 patients, 63%). In addutuib. the inferior wall of the orbit was the most frequent site of fracture(22 patients, 81%). The interval between the onset of injury and the operatuib averaged 7.3days. The most common clinical sign helpful in diagnosing the blow-out fracture is the lid sign-ecchymosis and edema(26 patients, 96%); but, diplopia, positive forced duction test and enophthalmos were found in under 30% of the cases. The operations were done by infraciliary approach in most cases, and a silastic sheet was firmly attached to the site of fracture with cyanoacrylate. In all cases examined, there were no significant complications. In conclusion, I am convinced that the use of cyanoacrylate during the placement of silastic sheet for the treatment of blow-out fracture makes a firm adhesion, prevents reherniation of tissue and protrusion of the implant and also reduces complications.
Cyanoacrylates*
;
Diplopia
;
Enophthalmos
;
Humans
;
Orbit
;
Orbital Fractures*