Randomized prospective study of the influence of steroids on postoperative eye-opening after exploration of the orbital floor

Flood, T.R.; McManners, J.; Attar, A. El; Moos, K.F.

doi:10.1054/bjom.1999.0024

Cited by 41 publications

(20 citation statements)

References 12 publications

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“…The material is well tolerated, resists infection, non antigenic and promotes tissue ingrowth. Its porous structure allows fibrovascularization which not only protects the implant from infection but also prevents its migration [20,[22][23][24][25].…”

Section: Discussionmentioning

confidence: 99%

Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction

Ram

Singh

Mohammad

et al. 2010

J. Maxillofac. Oral Surg.

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Aim The present study is to compare the effectiveness of iliac crest graft and medpor implant, for repairing traumatic orbital floor defects. Materials and methods A total of 20 patients were included in the study. Autogenous iliac crest graft and medpor implant was used in 10 patients of the each group. Patients were evaluated for the presence or absence of diplopia, enophthalmos, infraorbital nerve paresthesia, and ocular motility disorders. Surgical indications for orbital exploration included entrapment of orbital tissues, large orbital defect (greater than 50% of the orbital floor or more than 8 mm), or orbital floor defects with involvement of other zygomaticofrontal complex fractures. Results All patients were successfully treated by restoration of the orbital wall continuity. Follow-up was done at 1-12 weeks. One patient had postoperative infection. There was no graft extrusion. Conclusions Both the groups showed satisfactory results, but group II was better than group I, as there was no donor site morbidity. Porous polyethylene (Medpor) is a biocompatible and high-density polyethylene implant. It is well tolerated by surrounding tissue, and its porous structure is rapidly infiltrated by host tissue. It is a highly stable and somewhat flexible porous alloplast that has rapid tissue in growth into its pores.

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Section: Discussionmentioning

confidence: 99%

Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction

Ram

Singh

Mohammad

et al. 2010

J. Maxillofac. Oral Surg.

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“…5 Their main role involves limitation of swelling at the surgical site. The primary factor in development of postoperative oedema involves an increase in water content in damaged tissue.…”

Section: Discussionmentioning

confidence: 99%

Steroid-induced psychosis complicating orthognathic surgery: A case report

Fleming¹,

Flood

2005

Br Dent J

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“…There were no significant differences in facial swelling between the steroid treated group and the untreated patients on any occasion. Flood et al (1999). 6 conducted a prospective, randomized, double-blind trial; 20 patients who require orbital floor exploration after injuries selected.…”

Section: Review Of Literaturementioning

confidence: 99%

“…Flood et al (1999). 6 conducted a prospective, randomized, double-blind trial; 20 patients who require orbital floor exploration after injuries selected. Patients were given Methylprednisolone 250 mg (or placebo identically packaged) at induction of anaesthesia with a further three doses at 6 hourly intervals postoperatively.…”

Section: Review Of Literaturementioning

confidence: 99%

“…Proponents of steroid use (Nordstrom et al 5 , Flood et al 6 and Gurlek et al 7 ) claim, it decreases postoperative oedema, decreases ecchymosis, improves surgical outcome, reduces home convalescence, decreases hospital stay and causes euphoria. Opponents of steroid use (Munro et al, 8 Rapaport et al 9 and Owsley et al 10 ) claim lack of evidence, serious complications like inhibition of Hypothalamic-PituitaryAdrenal axis, avascular necrosis of hip and humerus, alter blood sugar levels, increase risk of hypertension, increase in the incidence of wound infection, and lack of cost effectiveness.…”

Section: Introductionmentioning

confidence: 99%

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Role of Corticosteroids in Reduction of Post-Operative Oedema in Craniofaciomaxillary Surgery

Malhari¹,

Sharma²,

Rattan³

2016

jemds

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Postoperative oedema and ecchymosis are common complaints following facial plastic surgical procedures. The resulting oedema and ecchymosis is socially disturbing and sometimes frightening for the patient. Serious consequences of oedema include airway obstruction, conjunctival chemosis with possible transient loss of vision and pain. Perioperative administration of steroids has been used in Craniofaciomaxillary procedures with a belief that it reduces postoperative swelling and shortens time to recovery after surgery. Various perioperative regimens of systemic corticosteroid administration have been reported to result in a significant reduction in postoperative facial oedema following cranioplasty, orbital floor exploration, mandibular and maxillary osteotomy, facial plasty, hair transplant and rhinoplasty. A number of experimental animal studies have demonstrated decreased oedema in flap models or replants. However, several clinical studies evaluating the use of steroids perioperatively in a variety of orthognathic and facial surgical procedures have failed to provide concrete evidence for or against steroid usage. Proponents of steroid use (Nordstrom et al, Flood et al and Gurlek et al) claim, it decreases postoperative oedema, decreases ecchymosis, improves surgical outcome, reduces home convalescence, decreases hospital stay and causes euphoria. Opponents of steroid use (Munro et al, Rapaport et al, and Owsley et al) claim lack of evidence, serious complications like inhibition of Hypothalamic Pituitary-Adrenal axis, avascular necrosis of hip and humerus, alter blood sugar levels, increased risk of hypertension, increase in the incidence of wound infection and lack of cost effectiveness. A prospective double-blind study conducted to evaluate the role of Dexamethasone 8 mg intravenous administration and Triamcinolone 0.7 mg/kg administration at the end of procedure in reduction of postoperative facial oedema in Craniofaciomaxillary surgeries. Thirty-four consecutive patients were randomized to Dexamethasone, Triamcinolone administration and control group. Facial size was measured on POD1, POD2 and POD3. Facial oedema scores were derived from comparison of photographs on admission and 48 hrs. postoperatively. Findings were tabulated and statistically analysed. Following observations were noted. The duration of surgery and postoperative facial oedema did not correlate. We found that oedema was maximum in the periorbital region in all the three groups followed by oedema on forehead, malar and mandibular regions. We also observed that there was direct correlation between forehead and periorbital oedema. We observed that there was postoperative facial oedema on POD1, reached its peak on POD2 and then started declining within each group. The use of steroids either intravenous (8 mg Dexamethasone) or local infiltration (Triamcinolone 0.7 mg/kg) did not significantly reduce the postoperative facial oedema in our patient when compared to the control.

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Randomized prospective study of the influence of steroids on postoperative eye-opening after exploration of the orbital floor

Cited by 41 publications

References 12 publications

Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction

Efficacy of Iliac Crest vs. Medpor in Orbital Floor Reconstruction

Steroid-induced psychosis complicating orthognathic surgery: A case report

Role of Corticosteroids in Reduction of Post-Operative Oedema in Craniofaciomaxillary Surgery

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