RESUMO
BACKGROUND: This study aims to assess the efficacy of transconjunctival approach (TCA) for the treatment of orbital fractures (OF) comprehensively and systematically. METHODS: In this study, we plan to search electronic databases of Cochrane Library, MEDLINE, EMBASE, Web of Science, Allied and Complementary Medicine Database, Chinese Biomedical Literature Database, China National Knowledge Infrastructure and for relevant randomized controlled trials. All these databases will be searched from inception to the March 1, 2020 without limitations of language and publication status. Two independent authors will carry out study selection, data collection, and study quality assessment. Any disagreements will be resolved by discussion with another author if necessary. The study quality will be assessed using Cochrane risk of bias tool. Statistical analysis will be conducted using RevMan 5.3 software. RESULTS: This study will be the first 1 to exert direct evidence to evaluate the efficacy of TCA for the treatment of OF. CONCLUSIONS: The findings of this study will provide an exhaustive view of TCA for the treatment of OF. STUDY REGISTRATION NUMBER: INPLASY202040154.
Assuntos
Túnica Conjuntiva/cirurgia , Fraturas Orbitárias/patologia , Fraturas Orbitárias/cirurgia , China/epidemiologia , Túnica Conjuntiva/anatomia & histologia , Humanos , Ensaios Clínicos Controlados Aleatórios como Assunto , Projetos de Pesquisa , Resultado do Tratamento , Metanálise como AssuntoRESUMO
This case report describes an infectious complication related to the use of calcified triglyceride (Kryptonite Bone Cement) in post-traumatic midface reconstruction. Ultimately, the infected material required removal, and the facial deformity was repaired with subsequent procedures. The literature suggests that bone cement products should be used with caution when in contact with the paranasal sinuses.
Assuntos
Óleo de Rícino/efeitos adversos , Infecções Oculares Bacterianas/etiologia , Procedimentos de Cirurgia Plástica , Polímeros/efeitos adversos , Infecções Estafilocócicas/etiologia , Infecções Estreptocócicas/etiologia , Infecção da Ferida Cirúrgica/etiologia , Adulto , Placas Ósseas , Infecções Oculares Bacterianas/diagnóstico por imagem , Infecções Oculares Bacterianas/terapia , Fixação Interna de Fraturas , Seio Frontal/lesões , Humanos , Masculino , Fraturas Maxilares/cirurgia , Seio Maxilar/lesões , Fraturas Orbitárias/cirurgia , Fraturas Cranianas/cirurgia , Infecções Estafilocócicas/diagnóstico por imagem , Infecções Estafilocócicas/terapia , Infecções Estreptocócicas/diagnóstico por imagem , Infecções Estreptocócicas/terapia , Infecção da Ferida Cirúrgica/diagnóstico por imagem , Infecção da Ferida Cirúrgica/terapia , Tomografia Computadorizada por Raios X , Fraturas Zigomáticas/cirurgiaRESUMO
Mydriasis, either bilateral or unilateral, seldom occurs during reconstruction of periorbital fracture. Anisocoria, a unilateral mydriasis, requires more urgent assessment than bilateral mydriasis does. Pharmacologic agents, local anesthetic infiltration, as well as direct or indirect oculomotor nerve damage are possible causes of unilateral mydriasis. Few cases have been reported about intraoperative temporary ipsilateral mydriasis during correction of blowout fracture. We have experienced an unusual case of anisocoria and report the case with literature reviews.
Assuntos
Complicações Intraoperatórias/etiologia , Midríase/etiologia , Doenças do Nervo Oculomotor/etiologia , Fraturas Orbitárias/cirurgia , Adulto , Anestesia Local/efeitos adversos , Traumatismos em Atletas/cirurgia , Beisebol/lesões , Humanos , MasculinoRESUMO
Treatment of facial trauma sequelae is a complex and challenging process. There is still controversy over suitable materials for orbital wall reconstruction. This study evaluated calcium phosphate cement (CPC) implants manufactured by rapid prototyping in the repair of orbital wall defects secondary to trauma. Computed tomographic scans of 5 patients were used for surgery planning and production of CPC implants. Implants were used to restore orbital wall anatomy, ocular alignment, and facial contour. Benefits resulting from the use of implants, such as a reduced operating time, patient response to biomaterial implantation, biomaterial integrity and stability, and patient satisfaction with treatment, were analyzed qualitatively. Our results suggest that CPC is an effective and safe material for orbital reconstruction because of its biocompatibility and easy production and placement.
Assuntos
Materiais Biocompatíveis/uso terapêutico , Substitutos Ósseos/uso terapêutico , Fosfatos de Cálcio/uso terapêutico , Órbita/cirurgia , Fraturas Orbitárias/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Próteses e Implantes , Adulto , Materiais Biocompatíveis/química , Substitutos Ósseos/química , Fosfatos de Cálcio/química , Sulfato de Cálcio/química , Desenho Assistido por Computador , Diplopia/cirurgia , Enoftalmia/cirurgia , Feminino , Humanos , Processamento de Imagem Assistida por Computador , Masculino , Pessoa de Meia-Idade , Transtornos da Motilidade Ocular/cirurgia , Doenças Orbitárias/cirurgia , Planejamento de Assistência ao Paciente , Segurança do Paciente , Satisfação do Paciente , Fosfatos/química , Estudos Prospectivos , Desenho de Prótese , Fatores de Tempo , Tomografia Computadorizada Espiral , Resultado do TratamentoAssuntos
Doenças Palpebrais/cirurgia , Pálpebras/cirurgia , Fraturas Orbitárias/cirurgia , Procedimentos de Cirurgia Plástica/métodos , Doenças Palpebrais/classificação , Doenças Palpebrais/etiologia , Pálpebras/patologia , Humanos , Massagem , Fraturas Orbitárias/complicações , Cuidados Pós-Operatórios , Complicações Pós-Operatórias/cirurgiaRESUMO
PURPOSE: The computed tomography (CT) scan is currently the gold standard in the imaging of orbital fractures. The weak points of this imaging modality, however, include restricted soft tissue depiction as well as the radiation. Both attributes are of particular importance in children because of the high rate of trapdoor fractures and the radiation to the lens. Although magnetic resonance imaging (MRI) is not associated with these drawbacks, it has not been established in the primary diagnosis of pediatric orbital fractures. The aim of our study was to establish the use of MRI with a special orbital coil for the primary diagnosis of pediatric orbital trauma. PATIENTS AND METHODS: In our retrospective study, 14 pediatric patients presented to our department with a blunt orbital trauma from 2003 to 2007. Twelve of 14 patients with orbital floor fractures required surgical reconstruction. Until 2004, imaging was carried out by plain x-rays and CT scan for a decision regarding the necessity of surgery. Since introducing the MRI microscopy orbital coil in 2004, CT scans have been replaced by MRI for the primary fracture diagnosis in 8 pediatric cases. Kappa statistics have been applied to assess inter- and intraobserver reliability for CT scans and MRI. This study shows our experiences using MRI in combination with conventional x-rays to determine the operative approach in 2 of the 8 pediatric cases suffering from blunt orbital trauma. RESULTS: The most common causes for pediatric orbital trauma in our collective were accidents. In 8 cases using MRI as the primary imaging modality, depiction of the fracture dislocation and differentiation of the adjacent fatty and muscle tissue was excellent and indication for surgery was distinct. MRI reached a high intra- and inter-rater agreement level (kappa=0.80). CONCLUSION: MRI combined with a microscopy orbital coil is a valuable alternative to the CT scan in the primary diagnosis of pediatric orbital fractures. Floor fractures, and particularly muscle incarceration, should be diagnosed by high resolution MRI combined with a microscopy coil instead of CT to avoid radiation to the lens and to obtain a better soft tissue depiction.
Assuntos
Imageamento por Ressonância Magnética/instrumentação , Fraturas Orbitárias/patologia , Adolescente , Criança , Tomada de Decisões , Humanos , Masculino , Variações Dependentes do Observador , Músculos Oculomotores/patologia , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Procedimentos de Cirurgia Plástica , Estudos Retrospectivos , Tomografia Computadorizada por Raios XRESUMO
PURPOSE: Closed hook reduction is a well-accepted approach in reducing selected cases of isolated orbitozygomatic complex fractures. The potential of achieving such reductions under light sedation and local anesthesia has many potential benefits over general anesthesia and should therefore not be overlooked. The goal of this study was to verify if closed reduction under local anesthesia is a feasible alternative to reduction under general anesthesia for selected cases of orbitozygomatic complex fractures. Furthermore, an attempt was made at identifying those who would benefit from such an option without compromising end results as opposed to those who would require open reduction with the use of internal fixation devices (ORIF) to ensure favorable outcomes. MATERIALS AND METHODS: Over the period of July to October 2005, we attempted to reduce 8 consecutive orbitozygomatic complex fractures on an outpatient basis with the use of local anesthesia. RESULTS: We have successfully reduced 6 of 8 such fractures. CONCLUSION: Closed hook reduction under light sedation and local anesthesia is a feasible and safe procedure in selected cases of noncomminuted zygomatic fractures. Coupling both physical examination and immediate postoperative radiographic evaluation ensures substantiation of accurate reduction and permits immediate final corrections if considered necessary.
Assuntos
Anestesia Local/métodos , Sedação Consciente/métodos , Fixação de Fratura/métodos , Fraturas Orbitárias/cirurgia , Fraturas Zigomáticas/cirurgia , Administração Sublingual , Adulto , Idoso , Procedimentos Cirúrgicos Ambulatórios/métodos , Anestésicos Locais/administração & dosagem , Carticaína/administração & dosagem , Feminino , Fixação de Fratura/instrumentação , Humanos , Hipnóticos e Sedativos/administração & dosagem , Injeções Intravenosas , Lorazepam/administração & dosagem , Masculino , Pessoa de Meia-IdadeRESUMO
A 46-year-old man with a history of right orbital fractures and blindness underwent simultaneous fracture repair and enucleation with orbital implantation. During surgery, an orbital catheter was placed for administering local anesthesia to control postoperative pain. After administration of local anesthesia through the catheter on postoperative day 1, the patient had development of a complete ptosis, total ophthalmoplegia, mydriasis, vision loss from 20/20 to NLP, and hypesthesia of the V1 and V2 trigeminal nerve distribution. Intraocular pressures and dilated funduscopic examination were normal. There was no evidence of central nervous system effects or respiratory depression. After 4 hours of observation, the vision, sensation, motility, ptosis, and pupil response all returned to normal. Although rare, contralateral cavernous sinus/orbital apex syndrome may occur with indwelling orbital catheter administration of local anesthetic in an orbit with fractures.
Assuntos
Cateteres de Demora/efeitos adversos , Seio Cavernoso , Doenças Orbitárias/etiologia , Anestesia Local/instrumentação , Anestésicos Locais/administração & dosagem , Enucleação Ocular , Seguimentos , Humanos , Injeções , Masculino , Pessoa de Meia-Idade , Órbita , Doenças Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/diagnóstico por imagem , Fraturas Orbitárias/cirurgia , Dor Pós-Operatória/terapia , Síndrome , Tomografia Computadorizada por Raios XRESUMO
Simulated Brown syndrome is a term applied to a myriad of disorders that cause a Brown syndrome-like motility. We encountered a case of acquired simulated Brown syndrome in a 41-year-old man following surgical repair of fractures of both medial orbital walls. He suffered from diplopia in primary gaze, associated with hypotropia of the affected eye. We performed an ipsilateral recession of the left inferior rectus muscle as a single-stage intraoperative adjustment procedure under topical anesthesia, rather than the direct approach to the superior oblique tendon. Postoperatively, the patient was asymptomatic in all diagnostic gaze positions.
Assuntos
Diplopia/etiologia , Transtornos da Motilidade Ocular/etiologia , Fraturas Orbitárias/cirurgia , Complicações Pós-Operatórias , Adulto , Anestesia Local , Diplopia/cirurgia , Movimentos Oculares , Humanos , Masculino , Transtornos da Motilidade Ocular/diagnóstico por imagem , Transtornos da Motilidade Ocular/cirurgia , Músculos Oculomotores/cirurgia , Procedimentos Cirúrgicos Oftalmológicos , Fraturas Orbitárias/diagnóstico por imagem , Estrabismo/etiologia , Estrabismo/cirurgia , Tomografia Computadorizada por Raios X , Visão BinocularAssuntos
Traumatismos Faciais/reabilitação , Músculos Faciais/efeitos da radiação , Terapia com Luz de Baixa Intensidade , Traumatismos Oculares/radioterapia , Traumatismos Oculares/reabilitação , Traumatismos Oculares/cirurgia , Movimentos Oculares/efeitos da radiação , Traumatismos Faciais/radioterapia , Traumatismos Faciais/cirurgia , Músculos Faciais/cirurgia , Humanos , Fraturas Orbitárias/radioterapia , Fraturas Orbitárias/reabilitação , Fraturas Orbitárias/cirurgiaRESUMO
Four patients underwent successful repair of an isolated orbital floor fracture under local anesthesia. The surgical approach was by antero-inferior orbitotomy, with placement of a Nylamid plate (S Jackson Inc, Washington, DC). The anesthetic technique used was a peribulbar and infratrochlear nerve block with local supplementation. Digital control of the globe was maintained during the peribulbar injection to prevent ocular perforation. We conclude that local anesthetic for this procedure in carefully selected cases is safe and efficacious, avoiding the morbidity of a general anesthetic.