Complex Orbital Fractures: Three-Dimensional Planning and Combined Surgical Approach

Abstract

Nowadays the development of diagnostic imaging, surgical techniques, alloplastic materials, and surgical instruments has made possible a more accurate management of orbital fractures. The aim of the present study was the management of orbital fractures and the solution of particular cases. The use of high-resolution computed tomography makes possible to gain a better understanding of the complex orbit anatomical structure. Also endoscopy is a valid alternative for medial orbital wall fractures treatment. It gives high control of the fracture site and its reduction. When this technology is combined with 3-dimensional (3D) reformatted images, it allows us to reconstruct more accurately the orbital defects. The authors present their experience in complex orbital fractures treated with the aim of the 3D navigation using a preformed orbital titanium plate. Endosopical approach was used to control plate positioning.

Differences in Angular Photogrammetric Soft-Tissue Facial Characteristics among Parents and Their Offspring

“…Soft-tissue analysis using appropriate images of human faces (i.e., photogrammetry), has been used for a few decades to evaluate both developmental and age-related changes, as well as population variables in humans [1,2]. This method has primarily been utilized in orthodontics, genetics, maxillofacial and plastic surgery for diagnosis, treatment planning, and post-operative assessment [3,4,5,6]. Additionally, facial morphology is a useful tool for other scientific disciplines, such as anthropology, forensic science, sociology, psychology, and so on, with a common goal of investigating factors that affect facial morphology in different populations/states [7,8,9].…”

Validity of computed tomography in diagnosing midfacial fractures

“…We identified a statistically significant difference between the CT examination and the gold standard in 10 out of 12 orbital fractures for the three 2D-CT planes, while for the 3D-CT a difference was observed only for fractures of the orbital floor, suggesting these are more accurate. However in some cases, the use of 3D and 2D CT images will still need to be complimented during surgery with a sinus endoscopy to confirm orbital floor fractures 27 .…”

Clinical Results According to Inferior Oblique Manipulation in Patients with Inferomedial Blowout Fracture Involving the Orbital Strut

“…4 However, restoring the natural curves of the orbital wall without postoperative sequelae remains challenging, as the inferior oblique muscle (IOM) impedes access to the medial and inferior orbital wall. [5][6][7][8] Although several procedures and techniques have been developed to increase the surgical view and treat these complicated fractures, no consensus on the ideal approach exists, and definite guidelines are lacking.…”