1.Three-dimensional computer navigation in the reconstruction of complex unilateral orbital fractures: evaluation and review of applications
Parampreet Singh SAINI ; Rajesh KUMAR ; Manu SAINI ; Tarush GUPTA ; Sunil GABA ; Ramesh Kumar SHARMA
Archives of Craniofacial Surgery 2024;25(4):161-170
Background:
The eyes are the central aesthetic unit of the face. Maxillofacial trauma can alter facial proportions and affect visual function with varying degrees of severity. Conventional approaches to reconstruction have numerous limitations, making the process challenging. The primary objective of this study was to evaluate the application of three-dimensional (3D) navigation in complex unilateral orbital reconstruction.
Methods:
A prospective cohort study was conducted over 19 months (January 2020 to July 2021), with consecutive enrollment of 12 patients who met the inclusion criteria. Each patient was followed for a minimum period of 6 months. The principal investigator carried out a comparative analysis of several factors, including fracture morphology, orbital volume, globe projection, diplopia, facial morphic changes, lid retraction, and infraorbital nerve hypoesthesia.
Results:
Nine patients had impure orbital fractures, while the remainder had pure fractures. The median orbital volume on the normal side (30.12 cm3; interquartile range [IQR], 28.45–30.64) was comparable to that of the reconstructed orbit (29.67 cm3; IQR, 27.92–31.52). Diplopia improved significantly (T(10) = 2.667, p = 0.02), although there was no statistically significant improvement in globe projection. Gross symmetry of facial landmarks was achieved, with comparable facial width-to-height ratio and palpebral fissure lengths. Two patients reported infraorbital hypoesthesia at presentation, which persisted at the 6-month follow-up. Additionally, five patients developed lower lid retraction (1–2 mm), and one experienced implant impingement at the infraorbital border.
Conclusion
Our study provides level II evidence supporting the use of 3D navigation to improve surgical outcomes in complex orbital reconstruction.
2.Three-dimensional computer navigation in the reconstruction of complex unilateral orbital fractures: evaluation and review of applications
Parampreet Singh SAINI ; Rajesh KUMAR ; Manu SAINI ; Tarush GUPTA ; Sunil GABA ; Ramesh Kumar SHARMA
Archives of Craniofacial Surgery 2024;25(4):161-170
Background:
The eyes are the central aesthetic unit of the face. Maxillofacial trauma can alter facial proportions and affect visual function with varying degrees of severity. Conventional approaches to reconstruction have numerous limitations, making the process challenging. The primary objective of this study was to evaluate the application of three-dimensional (3D) navigation in complex unilateral orbital reconstruction.
Methods:
A prospective cohort study was conducted over 19 months (January 2020 to July 2021), with consecutive enrollment of 12 patients who met the inclusion criteria. Each patient was followed for a minimum period of 6 months. The principal investigator carried out a comparative analysis of several factors, including fracture morphology, orbital volume, globe projection, diplopia, facial morphic changes, lid retraction, and infraorbital nerve hypoesthesia.
Results:
Nine patients had impure orbital fractures, while the remainder had pure fractures. The median orbital volume on the normal side (30.12 cm3; interquartile range [IQR], 28.45–30.64) was comparable to that of the reconstructed orbit (29.67 cm3; IQR, 27.92–31.52). Diplopia improved significantly (T(10) = 2.667, p = 0.02), although there was no statistically significant improvement in globe projection. Gross symmetry of facial landmarks was achieved, with comparable facial width-to-height ratio and palpebral fissure lengths. Two patients reported infraorbital hypoesthesia at presentation, which persisted at the 6-month follow-up. Additionally, five patients developed lower lid retraction (1–2 mm), and one experienced implant impingement at the infraorbital border.
Conclusion
Our study provides level II evidence supporting the use of 3D navigation to improve surgical outcomes in complex orbital reconstruction.
3.Three-dimensional computer navigation in the reconstruction of complex unilateral orbital fractures: evaluation and review of applications
Parampreet Singh SAINI ; Rajesh KUMAR ; Manu SAINI ; Tarush GUPTA ; Sunil GABA ; Ramesh Kumar SHARMA
Archives of Craniofacial Surgery 2024;25(4):161-170
Background:
The eyes are the central aesthetic unit of the face. Maxillofacial trauma can alter facial proportions and affect visual function with varying degrees of severity. Conventional approaches to reconstruction have numerous limitations, making the process challenging. The primary objective of this study was to evaluate the application of three-dimensional (3D) navigation in complex unilateral orbital reconstruction.
Methods:
A prospective cohort study was conducted over 19 months (January 2020 to July 2021), with consecutive enrollment of 12 patients who met the inclusion criteria. Each patient was followed for a minimum period of 6 months. The principal investigator carried out a comparative analysis of several factors, including fracture morphology, orbital volume, globe projection, diplopia, facial morphic changes, lid retraction, and infraorbital nerve hypoesthesia.
Results:
Nine patients had impure orbital fractures, while the remainder had pure fractures. The median orbital volume on the normal side (30.12 cm3; interquartile range [IQR], 28.45–30.64) was comparable to that of the reconstructed orbit (29.67 cm3; IQR, 27.92–31.52). Diplopia improved significantly (T(10) = 2.667, p = 0.02), although there was no statistically significant improvement in globe projection. Gross symmetry of facial landmarks was achieved, with comparable facial width-to-height ratio and palpebral fissure lengths. Two patients reported infraorbital hypoesthesia at presentation, which persisted at the 6-month follow-up. Additionally, five patients developed lower lid retraction (1–2 mm), and one experienced implant impingement at the infraorbital border.
Conclusion
Our study provides level II evidence supporting the use of 3D navigation to improve surgical outcomes in complex orbital reconstruction.
4.Three-dimensional computer navigation in the reconstruction of complex unilateral orbital fractures: evaluation and review of applications
Parampreet Singh SAINI ; Rajesh KUMAR ; Manu SAINI ; Tarush GUPTA ; Sunil GABA ; Ramesh Kumar SHARMA
Archives of Craniofacial Surgery 2024;25(4):161-170
Background:
The eyes are the central aesthetic unit of the face. Maxillofacial trauma can alter facial proportions and affect visual function with varying degrees of severity. Conventional approaches to reconstruction have numerous limitations, making the process challenging. The primary objective of this study was to evaluate the application of three-dimensional (3D) navigation in complex unilateral orbital reconstruction.
Methods:
A prospective cohort study was conducted over 19 months (January 2020 to July 2021), with consecutive enrollment of 12 patients who met the inclusion criteria. Each patient was followed for a minimum period of 6 months. The principal investigator carried out a comparative analysis of several factors, including fracture morphology, orbital volume, globe projection, diplopia, facial morphic changes, lid retraction, and infraorbital nerve hypoesthesia.
Results:
Nine patients had impure orbital fractures, while the remainder had pure fractures. The median orbital volume on the normal side (30.12 cm3; interquartile range [IQR], 28.45–30.64) was comparable to that of the reconstructed orbit (29.67 cm3; IQR, 27.92–31.52). Diplopia improved significantly (T(10) = 2.667, p = 0.02), although there was no statistically significant improvement in globe projection. Gross symmetry of facial landmarks was achieved, with comparable facial width-to-height ratio and palpebral fissure lengths. Two patients reported infraorbital hypoesthesia at presentation, which persisted at the 6-month follow-up. Additionally, five patients developed lower lid retraction (1–2 mm), and one experienced implant impingement at the infraorbital border.
Conclusion
Our study provides level II evidence supporting the use of 3D navigation to improve surgical outcomes in complex orbital reconstruction.
5.Bilateral Total Hip Arthroplasty in a Rare Case of Multicentric Reticulohistiocytosis.
Balaji SAIBABA ; Ramesh Kumar SEN ; Ashim DAS ; Aman SHARMA
Clinics in Orthopedic Surgery 2015;7(4):509-514
Multicentric reticulohistiocytosis (MRH) is a rare systemic disease, which commonly manifests as muco-cutaneous papulonodules and inflammatory erosive polyarthropathy. In this research, we report the clinical manifestations and management of a rare case of MRH with destructive arthropathy of bilateral hip joints and arthritis mutilans presenting with characteristic deformities. Disabling hip arthropathy that occurs secondary to MRH can be successfully managed with bilateral total hip arthroplasty (THA). Osteopenia and acetabular bone defects must be anticipated during THA. This case is reported due to its rare occurrence and because little literature has been published regarding THA in such patients.
*Arthroplasty, Replacement, Hip
;
Fingers/pathology
;
Hip/pathology/radiography/surgery
;
*Histiocytosis, Non-Langerhans-Cell
;
Humans
;
Skin/pathology
;
Toes/pathology