Clinical recommendations for repair of orbital facial fractures

Burnstine, Michael A.

doi:10.1097/00055735-200310000-00002

Cited by 201 publications

(145 citation statements)

References 33 publications

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“…The diagnosis is based on clinical features and imaging studies (1,2) . It is very important to do a computerized scan and, sometimes, MRI (Magnetic Resonance Imaging) because simple X-rays do not allow seeing soft-tissue structures in detail (1,3,4) . Less common than the floor fracture is the orbital medial wall fracture, with lesion of the lamina papiracea which, in that case, makes an otorhinolaryngological and craniofacial intervention necessary.…”

Section: Introductionmentioning

confidence: 99%

Traumatic orbital fracture with intact ocular globe displacement into the maxillary sinus

Damasceno¹,

Damasceno²

2010

Rev. bras.oftalmol.

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Section: Introductionmentioning

confidence: 99%

Traumatic orbital fracture with intact ocular globe displacement into the maxillary sinus

Damasceno¹,

Damasceno²

2010

Rev. bras.oftalmol.

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“…Blumer Michael, MD 1) , Gander Thomas, MD, DMD 2) , Kruse Gujer Astrid, MD, DMD 2) , Seifert Burkhardt, Prof. Dr. 4) , Rücker Martin, MD, DMD 5) , Lübbers Heinz-Theo, MD, DMD …”

Section: Influence Of Mirrored Ct Scans On Decision-making For Revisimentioning

confidence: 99%

“…Various studies have discussed indications and timing for operative repair of orbital floor fractures because oculo-facial surgery is not risk-free [2]. If not operated on in time and appropriately, complications like enophthalmia or diplopia may occur [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Blumer

Gander

Gujer

et al. 2015

Journal of Oral and Maxillofacial Surgery

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PURPOSE This study evaluated whether intraoperative imaging with computer-assisted virtual reconstruction would be advantageous in reconstructions of orbital floor fractures. The surgeon's intention to revise a reconstructed primary orbital floor fracture by evaluating a postoperative mirrored computed tomographic (CT) scan was analyzed intraoperatively before wound closure, during inpatient hospitalization, and after hospitalization. The inter-rater agreement and the match of intention to revise and actual revision were analyzed. MATERIALS AND METHODS Fifty-one anonymized postoperative CT scans of patients with a unilateral orbital floor fracture were mirrored using software. These computer-assisted virtual reconstructions were consecutively examined by 4 examiners. Seven of these patients underwent a revision. In the first part, the inter-rater agreements for all 3 times were analyzed. In the second part, the examiners' intentions to revise were compared with the actual performed revisions. RESULTS The overall inter-rater agreements were 0.69 for the intraoperative phase, 0.55 for the in-hospital phase, and 0.39 for the post-hospital phase. The intraoperative inter-rater agreement for each examiner was 0.58 to 0.80. The Fleiss value for the in-hospital and post-hospital phases was lower. The comparison of the examiners' intention to revise and the actual revisions showed that 15 to 24 additional would have been revised. In contrast, 6 of 7 actual revisions would have been revised intraoperatively. The missed actual revision was the same case by all 4 examiners. The accordance of intention to revise with the actual revisions decreased during hospitalization and even more after hospitalization. This study showed strong agreement among examiners for revising anatomically incorrectly reduced orbital floor fractures intraoperatively by evaluating postoperative mirrored CT scans. During the in-hospital and post-hospital phases, the restraints against revision seemed to increase, thus leading to poorer interrater agreement. This analysis of postoperative CT scans with computer-assisted virtual reconstructions of the orbit would have led to considerably more revisions intraoperatively, but all actual revisions were detected except for 1 case. This case was the same for all 4 examiners. Operation time would have been prolonged in the additional revised cases, but a better anatomic reconstruction would have been achieved. Furthermore, the intraoperative result of the reconstruction would have been controlled instantly and corrected immediately, if needed. CONCLUSION This study showed that of 6 of 7 actual revisions, implant placement would have been revised intraoperatively by all 4 examiners, if intraoperative imaging with computer-assisted virtual reconstruction of the orbit would have been applied. Therefore, the authors suggest that intraoperative imaging with computer-assisted virtual reconstruction could be advantageous in the prevention of later revisions of orbital floor fractures. In this study, the t...

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“…The complex geometry of the bony orbit makes anatomic reconstruction extremely challenging, particularly in two-wall fractures. A review of the literature reveals the use of multiple surgical approaches and multiple implant materials for reconstruction [7][8][9][10]. Despite a large body of literature, these injuries remain some of the most difficult reconstructive challenges in maxillofacial surgery [11][12][13][14][15].…”

Section: Acknowledgmentsmentioning

confidence: 99%

Computer Assisted Head and Neck, and ENT Surgery

2007

Int J CARS

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Mandibular body resection demands a considerable amount of time spent by fitting, trimming and/or bending standard reconstruction plates. Moreover, bone fractures or erosion could make anatomically correct plate shaping difficult. Therefore, semi-automated and application-specific planning software was developed to reconstruct unilateral bone erosions or fractures; to outline segmental resection; to design patient-specific standard reconstruction plates or custom titanium membranes and scaffold macro-shapes. Screw lengths are automatically assessed and interference with the inferior alveolar nerve detected. The average gain of operative time and accuracy using these procedures was assessed by an experimental study of plate bending and a number of retrospective and prospective clinical cases.

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Clinical recommendations for repair of orbital facial fractures

Abstract: Orbital facial fracture management is germane to ophthalmologists, plastic surgeons, otolaryngologists, and others who treat patients.

Cited by 201 publications

References 33 publications

Traumatic orbital fracture with intact ocular globe displacement into the maxillary sinus

Traumatic orbital fracture with intact ocular globe displacement into the maxillary sinus

Influence of Mirrored Computed Tomograms on Decision-Making for Revising Surgically Treated Orbital Floor Fractures

Computer Assisted Head and Neck, and ENT Surgery

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