Ophthalmic outcomes of fractured zygomas

McGalliard, Rachel; Kimpton, James; McLeod, Niall

doi:10.1016/j.bjoms.2016.10.026

Cited by 8 publications

(5 citation statements)

References 19 publications

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“…A variety of defects in the orbital wall can be captured with CT imaging ranging from hairline fractures without displacement to full separation of orbital bones which can cause tissue prolapse in the eye socket and surrounding orbitomaxillary structures including the cheek bone and detached facial muscles. During repair of the injury to the zygoma, early exploration of the internal orbit can provide a foundation for later cosmetic surgery by rebuilding the orbital floor [12]. In this patient, we report a succesful repair using a mesh floor to support the subsequent face lift and cosmetic tissue repair.…”

Section: Discussionmentioning

confidence: 99%

Neglected orbitozygomaticomaxillary fractures with complications: A case report

Wahdini

Dachlan

Seswandhana

et al. 2019

International Journal of Surgery Case Reports

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Highlights Zygomatic complex fractures can involve surrounding structures and cause serious ophthalmic and aesthetic complications. Radiological investigations is very useful in diagnosing and planning the reconstruction surgery. The goal of fracture reconstructions is to restore the appearance and skeletal anatomy before injury instead of bone healing. Immediate reconstruction is recommended to prevent more complications. 3-D model reconstruction can provide better accuracy but takes longer time.

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Section: Discussionmentioning

confidence: 99%

Neglected orbitozygomaticomaxillary fractures with complications: A case report

Wahdini

Dachlan

Seswandhana

et al. 2019

International Journal of Surgery Case Reports

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“…Current evidence in the literature favors a more selective approach to exploring and repairing the OF during repair of ZMC fractures. [1][2][3][4] Proponents of selective OF exploration advocate that precise ZMC reduction corrects orbital volume without the need for OF exploration in most concurrent ZMC and OF fractures. Unnecessary OF exploration increases potential morbidity and adds to costs.…”

Section: Trends In Concurrent Orbital Floor Repair During Zygomaticom...mentioning

confidence: 99%

“…2 In addition, harvesting the masseteric nerve at a more distal point likely minimizes the risk of denervating the masseter muscle because in 90% of cases, the muscle has more than 1 branch at this level. 3 The additional advantage of the masseteric nerve over other nerve sources is its richer axonal content, which has been shown to account for increased muscle excursion 4 and a more selective and synergistic action than the hypoglossal neural supercharge. 5 In the case of weak facial muscles, direct neurotization preserves functioning facial nerve branches, allowing for dual innervation of facial muscles and the maximum amount of neural input possible for excursion.…”

mentioning

confidence: 99%

“…The need for concurrent OF repair during ZMC repair remains a topic of discussion. Current evidence in the literature favors a more selective approach to exploring and repairing the OF during repair of ZMC fractures . Proponents of selective OF exploration advocate that precise ZMC reduction corrects orbital volume without the need for OF exploration in most concurrent ZMC and OF fractures.…”

mentioning

confidence: 99%

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Trends in Concurrent Orbital Floor Repair During Zygomaticomaxillary Complex Fracture Repair

Flynn

Kriet

et al. 2019

JAMA Facial Plast Surg

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scores, 4 vs 8; 95% CI, 0.01 to 7.99; P = .049). The Terzis score for the open mouth smile significantly increased (mean, 2.5 vs 3.85; 95% CI, 0.12-1.34; P = .02) as did the smile index (mean, 7.5 vs 5.6; 95% CI, −3.47 to −0.34, P = .02). Masseter function was normal in all cases. These data are summarized in the Table and the clinical outcomes in 1 case are illustrated in the Figure . Discussion | This study has demonstrated that smile excursion can be substantially improved when the masseteric nerve is used to selectively neurotize preoperatively selected muscles as a means of customizing the smile vector. Initial concerns regarding the feasibility of the masseteric nerve as a donor nerve were addressed in the present cohort by careful clinical, electromyographic, and magnetic resonance imaging assessment of the masseter muscle. 2 In addition, harvesting the masseteric nerve at a more distal point likely minimizes the risk of denervating the masseter muscle because in 90% of cases, the muscle has more than 1 branch at this level. 3 The additional advantage of the masseteric nerve over other nerve sources is its richer axonal content, which has been shown to account for increased muscle excursion 4 and a more selective and synergistic action than the hypoglossal neural supercharge. 5 In the case of weak facial muscles, direct neurotization preserves functioning facial nerve branches, allowing for dual innervation of facial muscles and the maximum amount of neural input possible for excursion. The other benefit is the flexibility to target different muscle groups, depending on the requirements of the patient (multivectorial facial reanimation). Just as multivectorial free-tissue transfers are the new gold standard for irreversible muscle paralysis, 6 selective neurotization is our preferred option for improving the weak smile.

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“…Hence, practitioners should always bear in mind that ZMC fractures may be associated with orbital floor defects, in order to successfully identify them clinically and radiographically and plan appropriate and timely treatment 5,10,14 . The objective of the present study was to investigate the significance/need of routinely exploring the integrity of the orbital floor following open reduction of ZMC fractures, as a prerequisite for the reconstruction of selected orbital floor defects, depending on their size and complexity.…”

Section: Introductionmentioning

confidence: 99%