Imaging Evaluation of Facial Complex Strut Fractures

Casto, Antonio Lo; Priolo, Gian Domenico; Garufi, Antonio; Purpura, Pierpaolo; Salerno, Sergio; Tona, Giuseppe La; Coppolino, Francesco

doi:10.1053/j.sult.2012.06.003

Cited by 23 publications

(7 citation statements)

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“…1 In this respect, it is reasonable to presume that arithmetically bilateral fractures are associated with more than twice as many problems as unilateral fractures. Bilateral orbital fracture is clinically important to both ophthalmologists and craniofacial surgeons because the orbits contain both eyeballs and constitute the greater part of the midface.…”

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confidence: 99%

A Clinical Analysis of Bilateral Orbital Fracture

Roh¹,

Jung²,

Chi³

2014

Journal of Craniofacial Surgery

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Although bilateral orbital fracture can cause serious eyeball and facial skeletal problems, few reports have been issued on the topic. We analyzed the clinical features of bilateral orbital fracture by reviewing the medical records of 147 patients and compared bilateral and unilateral fractures by reviewing the literature.Bilateral orbital fracture was most common in men aged between 50 and 59 years. A traffic accident was the leading cause of trauma, and average time between trauma and surgery was 12.2 days. Bilateral medial fracture accompanied by nasal fracture accounted for the overwhelming majority, and impure blowout fracture in at least 1 eye occurred in 69.4% of the 147 patients. Associated ocular injuries seemed to be similar for bilateral and unilateral fracture. Thirty-five patients (23.8%) had other multiple traumas affecting other than the eyes, and this significantly increased the need for surgery (P < 0.05). Of the 48 patients who underwent surgery, including 4 cases of bilateral surgery, 21 patients who had ocular motility restriction with central diplopia within 30 degrees almost completely recovered. No significant relation between the timing of surgery and improvement was found. Although unilateral surgery was performed in most cases, facial asymmetry related to enophthalmos was unclear at 6 months postoperatively.In summary, bilateral orbital fracture was found to be clinically distinguishable from unilateral fracture in several aspects. We hope these findings provide a reference guide to the approach and management of bilateral orbital fracture.

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confidence: 99%

A Clinical Analysis of Bilateral Orbital Fracture

Roh¹,

Jung²,

Chi³

2014

Journal of Craniofacial Surgery

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“…The absence of enhancement is a sign of ineffective reperfusion which suggests the need for a surgical resection. In the NOMI, due to its pathogenesis, there is also an ischemic involvement of parenchymatous organs (liver, spleen, kidney) that should be carefully investigated [52]. …”

Section: Resultsmentioning

confidence: 99%

Mesenteric ischemia: the importance of differential diagnosis for the surgeon

et al. 2013

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BackgroundIntestinal ischemia is an abdominal emergency that accounts for approximately 2% of gastrointestinal illnesses. It represents a complex of diseases caused by impaired blood perfusion to the small and/or large bowel including acute arterial mesenteric ischemia (AAMI), acute venous mesenteric ischemia (AVMI), non occlusive mesenteric ischemia (NOMI), ischemia/reperfusion injury (I/R), ischemic colitis (IC). In this study different study methods (US, CT) will be correlated in the detection of mesenteric ischemia imaging findings due to various etiologies.MethodsBasing on our institutions experience, 163 cases of mesenteric ischemia/infarction from various cases, investigated with CT and undergone surgical treatment were retrospectively evaluated, in particular trought the following findings: presence/absence of arterial/venous obstruction, bowel wall thickness and enhancement, presence/absence of spastic reflex ileus, hypotonic reflex ileus or paralitic ileus, mural and/or portal/mesenteric pneumatosis, abdominal free fluid, parenchymal ischemia/infarction (liver, kidney, spleen).ResultsTo make an early diagnosis useful to ensure a correct therapeutic approach, it is very important to differentiate between occlusive (arterial, venous) and non occlusive causes (NOMI). The typical findings of each forms of mesenteric ischemia are explained in the text.ConclusionThe radiological findings of mesenteric ischemia have different course in case of different etiology. In venous etiology the progression of damage results faster than arterial even if the symptomatology is less acute; bowel wall thickening is an early finding and easy to detect, simplifying the diagnosis. In arterial etiology the damage progression is slower than in venous ischemia, bowel wall thinning is typical but difficult to recognize so diagnosis may be hard. In the NOMI before/without reperfusion the ischemic damage is similar to AAMI with additional involvement of large bowel parenchymatous organs. In reperfusion after NOMI and after AAMI the CT and surgical findings are similar to those of AVMI, and the injured bowel results quite easy to identify. The prompt recognition of each condition is essential to ensure a successful treatment.

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“…Only the orbital walls are disrupted in pure blow-out or blowin type fractures, whereas the orbital rim is routinely involved in more complex fracture patterns, such as orbitozygomatic fractures [27]. Reconstruction of the orbital walls cannot be undertaken until the orbital rim has been stabilized because the rim serves as an anchoring point for bone grafts or alloplastic implants [4].…”

Section: Postoperative Imaging Findings Overviewmentioning

confidence: 99%

Postoperative CT of the Orbital Skeleton After Trauma: Review of Normal Appearances and Common Complications

Reiter

Schwope

Theler

2016

American Journal of Roentgenology

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The goal of surgery is to restore the preinjury orbital anatomy to improve function and prevent enophthalmos. Radiologists need to be cognizant of the more frequently encountered operative procedures used for orbital fracture repair, the desired goals of treatment, and common complications. This will permit accurate interpretation of postoperative CT and provide surgeons with clinically useful results.

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Imaging Evaluation of Facial Complex Strut Fractures

Cited by 23 publications

References 10 publications

A Clinical Analysis of Bilateral Orbital Fracture

A Clinical Analysis of Bilateral Orbital Fracture

Mesenteric ischemia: the importance of differential diagnosis for the surgeon

Postoperative CT of the Orbital Skeleton After Trauma: Review of Normal Appearances and Common Complications

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