Orbitalization of Ethmoidal Sinus With Stacked Cross-linked Acellular Dermal Matrix: A New Strategy to Reconstruct Medial Orbital Wall Fracture

Park, Tae Hwan

doi:10.1097/scs.0000000000009504

Cited by 3 publications

(3 citation statements)

References 7 publications

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“…Various materials are available to reconstruct the orbital fractures. Titanium-reinforced porous polyethylene plates, 3,6,7 artificial dermal matrix, [9][10][11] resorbable magnesium biomaterials, 12 PDS foils and titanium meshes, 13 and absorbable plates. 14 Regardless of their pros and cons, each has its own best indications.…”

Section: Discussionmentioning

confidence: 99%

How to Reduce Inferomedial Orbital Wall Fracture Using a Navigation System: Tips and Pearls

Park

2024

Journal of Craniofacial Surgery

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The orbit is a confined space with a defined bony structure. Bony protrusion into the ethmoid or maxillary sinuses by the blowout fracture can displace orbital tissues, including rectus muscles and adjacent fascial septae. Especially, reconstructing the orbit’s floor and medial wall can be challenging when the inferomedial strut or posterior bony ledge is affected, leading to a loss of critical anatomic landmarks and support. Correctly positioning an implant in the precise anatomic location can be challenging. Recent updates to the navigation system have addressed this issue. Despite its early application, using a navigation system in these orbital fractures advances plastic surgeons in a way that has more confidence and accuracy in surgical planning. The video demonstrates how these 2 can be combined in an operating room. Intraoperatively, the authors check the superior, anterior, and posterior ends of the medial wall fracture and the posterior end of the floor fracture. A single orbital implant was trimmed and reshaped to match defect measurements. The implant placement was meticulously executed to repair the fracture while ensuring the inferior oblique muscle was not injured. After confirming the correct placement of the implant, it was secured to the inferior orbital rim using a single screw. Depending on the medial orbital wall fracture depth or degree of soft tissue herniation, the authors used an artificial dermal matrix or trimmed absorbable mesh plate to cover the uppermost part of the medial wall fracture to prevent postoperative enophthalmos. Finally, a forced duction test was performed. Our study shows that navigation-assisted inferomedial orbital wall reconstruction using materials readily available in the market is safe and effective.

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Section: Discussionmentioning

confidence: 99%

How to Reduce Inferomedial Orbital Wall Fracture Using a Navigation System: Tips and Pearls

Park

2024

Journal of Craniofacial Surgery

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“…This particular fracture type encompasses the orbital floor, medial wall, and intervening inferomedial orbital strut (IOS) [4]. The consequences of such a fracture can be significant, as it often leads to substantial herniation of orbital fat, causing expansion of the orbit and displacement of the globe [5]. Restoring this fracture anatomically can be difficult due to limited structural support [6].…”

Section: Introductionmentioning

confidence: 99%

The Usefulness of the Navigation System to Reconstruct Orbital Wall Fractures Involving Inferomedial Orbital Strut

Park

2023

JCM

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Background: Little attention has been paid to combined orbital floor and medial wall fractures with the involvement of the inferomedial orbital strut. Managing this particular fracture can prove challenging. However, various innovative techniques have been introduced to assist with the process. Our study focuses on sharing our approach to orbital wall reconstruction using navigation guidance and titanium-reinforced porous polyethylene plates, specifically cases involving the inferomedial orbital strut. We believe that implementing a navigation system can effectively lead surgeons to the fracture site with utmost safety. Also, we hypothesized that this navigation system is beneficial to use singe fan titanium-reinforced porous polyethylene plates with orbital wall fractures involving IOS while minimizing possible complications. Methods: We retrospectively reviewed 131 patients with medial orbital wall and orbital floor fractures with or without combined other facial bone fractures who underwent orbital wall reconstruction by a single surgeon from May 2021 to May 2023. Amongst, we identified fourteen orbital wall fractures involving the inferomedial orbital strut. We used a subciliary incision as the only approach method for performing titanium-reinforced porous polyethylene plates for navigation-guided orbital wall reconstruction. Patients were followed up for at least three months. Results: All cases were effectively resolved using titanium-reinforced porous polyethylene plates. There were no complications during the patient’s complete recovery, confirmed clinically and radiologically. Based on the serial CT results, it was discovered that implanted titanium-reinforced porous polyethylene plates successfully covered the defect. Conclusion: Based on our retrospective analysis, it has been determined that among the 131 recorded cases of orbital fractures, 14 of them (or 10.7%) involved the inferomedial orbital strut. Navigation-guided reduction using titanium-reinforced porous polyethylene (TR-PPE) plates can lead to predictable, reliable, and excellent outcomes for treating orbital fractures involving the inferomedial orbital strut without complications.

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“…F acial bone fractures are common medical conditions widely discussed in plastic surgery. [1][2][3][4][5][6]7 When this type of facial bone fracture is associated with a temporoparietal bone fracture, the fracture extends to involve the bones in the temporal and parietal regions of the skull. The temporal bone forms the lower lateral sides of the skull, and the parietal bone forms the upper sides.…”

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One-piece Craniofacial Bone Fracture Reduction With an Additional Single Osteotomy at the Zygomaticomaxillary Buttress: A Successful Reduction of Frontoorbitozygomaticomaxillary Fracture Associated With a Temporoparietal Bone Fracture

Park

2023

Journal of Craniofacial Surgery

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A frontoorbitozygomaticomaxillary fracture, also known as a complex midface fracture or “quadripod fracture,” is a type of facial fracture involving multiple midface region bones. This includes the frontal bone (forehead), orbitozygomatic complex (which includes the zygomatic bone or cheekbone and the orbital bones around the eye), and the maxillary bone (upper jaw). These complex midface fractures associated with temporoparietal bone fractures can occur in clinical practice. However, a single-piece fracture of these has not been reported before. This study reports a 44-year-old male patient with a significant frontoorbitozygomaticomaxillary fracture associated with a temporoparietal bone fracture combined with epidural hematoma at the superior aspect of unilateral frontoparietotemporal convexity. Surgical treatment was performed 3 weeks after the traumatic event. Despite craniotomy of the parietal bone fragment, the reduction was not possible. The facial bone reduction was finally achieved following an additional single osteotomy at the unilateral zygomaticomaxillary buttress. The follow-up CT scan taken immediately and 3 weeks postoperatively showed successful realignment of craniofacial bone fracture. In conclusion, a single-piece fracture of frontoorbitozygomaticomaxillary bone connected to a temporoparietal bone can require additional osteotomy to achieve successful outcomes in an acute setting.

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Orbitalization of Ethmoidal Sinus With Stacked Cross-linked Acellular Dermal Matrix: A New Strategy to Reconstruct Medial Orbital Wall Fracture

Cited by 3 publications

References 7 publications

How to Reduce Inferomedial Orbital Wall Fracture Using a Navigation System: Tips and Pearls

How to Reduce Inferomedial Orbital Wall Fracture Using a Navigation System: Tips and Pearls

The Usefulness of the Navigation System to Reconstruct Orbital Wall Fractures Involving Inferomedial Orbital Strut

One-piece Craniofacial Bone Fracture Reduction With an Additional Single Osteotomy at the Zygomaticomaxillary Buttress: A Successful Reduction of Frontoorbitozygomaticomaxillary Fracture Associated With a Temporoparietal Bone Fracture

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