Orthoptic Evaluation and Treatment in Orbital Fractures

Braaksma-Besselink, Yvette; Jellema, Hinke Marijke

doi:10.1016/j.cxom.2020.10.002

Cited by 4 publications

(2 citation statements)

References 21 publications

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“…This usually occurs due to ocular deviation caused by the entrapment of one or more extraocular muscles [16]. The fracture can also lead to the direct injury of the muscle, i.e., laceration, disinsertion, intramuscular hemorrhage, or damage to the nerve controlling eye movement [17]. In fractures involving more than half of the orbital floor, there is also the possibility of the hypoglobus likewise resulting to diplopia [2,16].…”

Section: Discussionmentioning

confidence: 99%

Clinical Significance of the Inferomedial Orbital Strut in Orbital Blowout Fractures: Incidence of Symptomatic Diplopia in a Fractured vs. Intact Strut

Someda,

Miyazaki,

Kakizaki

et al. 2024

JCM

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Background/Objectives: This study aims to compare the clinical findings, particularly symptomatic diplopia, associated with an inferomedial orbital strut fracture versus intact strut and to determine the clinical significance of the inferomedial orbital strut in patients with orbital floor and medial orbital wall fractures. Methods: A 10-year retrospective observational study involving orbital blowout fracture cases was conducted in our institution. Patients with fractures of the orbital floor medial to the infraorbital groove and medial orbital wall, as seen on computed tomography (CT) scans, were included in this study. Patients with concomitant orbital rim fracture and those with old orbital fractures were excluded. Fracture of the inferomedial orbital strut was diagnosed via coronal CT images and patients were classified into those with an inferomedial orbital strut fracture and those without. Results: A total of 231 orbits from 230 patients was included in the study (fractured strut on 78 sides and intact strut on 153 sides). Approximately 2/3 of patients in both groups had the field of binocular single vision in primary position upon first examination (p = 0.717). Patients with strut fractures demonstrated only comminuted or open fractures, while those without strut fractures showed diverse fracture patterns (p < 0.001). Conclusions: Inferomedial orbital strut fracture does not automatically result in diplopia in patients with orbital blowout fractures. The integrity of the orbital periosteum plays a more essential role in hampering extraocular muscle displacement, thereby preventing symptomatic diplopia in these patients.

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Section: Discussionmentioning

confidence: 99%

Clinical Significance of the Inferomedial Orbital Strut in Orbital Blowout Fractures: Incidence of Symptomatic Diplopia in a Fractured vs. Intact Strut

Someda,

Miyazaki,

Kakizaki

et al. 2024

JCM

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“…In these cases, it is advisable to perform several orthoptic assessments over time to monitor spontaneous improvement. Moreover, the orthoptist may be able to differentiate between possible causes of double vision through repeated measurements [9,28].…”

Section: Diagnosticsmentioning

confidence: 99%

Personalized Medicine Workflow in Post-Traumatic Orbital Reconstruction

Sabelis

Schreurs

Essig

et al. 2022

JPM

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Restoration of the orbit is the first and most predictable step in the surgical treatment of orbital fractures. Orbital reconstruction is keyhole surgery performed in a confined space. A technology-supported workflow called computer-assisted surgery (CAS) has become the standard for complex orbital traumatology in many hospitals. CAS technology has catalyzed the incorporation of personalized medicine in orbital reconstruction. The complete workflow consists of diagnostics, planning, surgery and evaluation. Advanced diagnostics and virtual surgical planning are techniques utilized in the preoperative phase to optimally prepare for surgery and adapt the treatment to the patient. Further personalization of the treatment is possible if reconstruction is performed with a patient-specific implant and several design options are available to tailor the implant to individual needs. Intraoperatively, visual appraisal is used to assess the obtained implant position. Surgical navigation, intraoperative imaging, and specific PSI design options are able to enhance feedback in the CAS workflow. Evaluation of the surgical result can be performed both qualitatively and quantitatively. Throughout the entire workflow, the concepts of CAS and personalized medicine are intertwined. A combination of the techniques may be applied in order to achieve the most optimal clinical outcome. The goal of this article is to provide a complete overview of the workflow for post-traumatic orbital reconstruction, with an in-depth description of the available personalization and CAS options.

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