Background: Trauma is one of the most common causes of enophthalmos, and post-traumatic enophthalmos primarily results from an increased volume of the bony orbit. We achieved good long-term results by simultaneously using an anatomical absorbable implant and iliac bone graft to correct post-traumatic enophthalmos. Methods: From January 2012 to December 2016, we performed operations on seven patients with post-traumatic enophthalmos. In all seven cases, reduction surgery for the initial trauma was performed at our hospital. Hertel exophthalmometry, clinical photography, three-dimensional computed tomography (3D-CT), and orbital volume measurements using software to calculate the specific volume captured on 3D-CT (ITK-SNAP, Insight Toolkit-SNAP) were performed preoperatively and postoperatively. Results: Patients were evaluated based on exophthalmometry, clinical photographs, 3D-CT, and orbital volume measured by the ITK-SNAP program at 5 days and 1 year postoperatively, and all factors improved significantly compared with the preoperative baseline. Complications such as hematoma or extraocular muscle limitation were absent, and the corrected orbital volume was well maintained at the 1-year follow-up visit. Conclusion: We present a method to correct enophthalmos by reconstructing the orbital wall using an anatomical absorbable implant and a simultaneous autologous iliac bone graft. All cases showed satisfactory results for enophthalmos correction. We suggest this method as a good option for the correction of post-traumatic enophthalmos.
A carotid-cavernous sinus fistula is a rare condition in which an abnormal communication exists between the internal or external carotid artery and the cavernous sinus. It typically occurs within a few weeks after craniomaxillofacial trauma. In most cases, the carotid-cavernous sinus fistula occurs on the same side as the craniomaxillofacial fracture. We report a case of delayed carotidcavernous sinus fistula that developed symptoms 7 months after the craniomaxillofacial fracture. The fistula developed on the side opposite to that of the craniomaxillofacial fracture. Based on our experience with this case, we recommend a long follow-up period of 7–8 months after the occurrence of a craniomaxillofacial fracture. We also recommend that the follow-up should include consideration of the side contralateral to the injury.
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The objective of this study was to review outcomes of early one-stage surgery of acutely infected preauricular sinus compared to conventional delayed surgery after infection control. The study is a case series with chart review conducted in an academic center. From January 1, 2007 to January 31, 2012, we performed surgical treatments for 136 congenital preauricular sinuses on 103 patients aged 0-15 years. We classified the sinuses according to the state of their infection at the time of the surgery intraoperatively--Group I (asymptomatic; n = 68, 50 %), Group II (infected state; n = 26, 19 %) and Group III (infected state with abscess formation; n = 42, 31 %). The surgical outcomes of Groups I, II, and III were documented during an outpatient department observation period. The follow-up period was from 6 months to over 2 years. One patient from Group II and one patient from Group III had a recurrent infection which could be managed by local infection control. One patient from Group I and one patient from Group III had skin defects by necrosis of a skin flap margin which could be secondarily healed. All patients had no recurrence or significant chronic complications. We performed early one-stage surgical treatments on a total of 136 sinuses with an even acute infection with abscess formation and achieved good surgical outcomes, and patients were satisfied in aspects of treatment period and cost. So we present our early one-stage surgical treatment as a good option for infected preauricular sinus management.
Dermatofibroma, also known as benign fibrous histiocytoma, is a benign tumor composed of fibroblastic and histiocytic cells. Dermatofibroma most frequently occurs in the dermis, but it can also be found in subcutaneous soft tissue in rare cases, particularly on the face. Herein, we report a case of pure subcutaneous dermatofibroma of the cheek, which was confirmed histopathologically with immunohistochemical staining. This report describes a pure subcutaneous dermatofibroma with a literature review and reminds surgeons to consider the possibility that dermatofibromas may occur in the subcutaneous layer before establishing their operative plan.
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