What surgical approach has the lowest risk of the lower lid complications in the treatment of orbital floor and periorbital fractures? A frequentist network meta-analysis

Al‐Moraissi, Essam Ahmed; Elsharkawy, Ahmed; Al-Tairi, Nashwan Hamid; Farhan, Abdullah; Abotaleb, Bassam; Alsharaee, Yasser; Oginni, Fadekemi Olufunmilayo; Al-zabidi, Ashraf

doi:10.1016/j.jcms.2018.09.001

Cited by 26 publications

(19 citation statements)

References 60 publications

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“…This rate was much lower than the preexisting literature. [4,9,10] In our opinion, meticulous repair of the orbital septum following insertion of the PPEI to the orbital floor is the main reason for our low rate of scleral show or other lower lid complications.…”

Section: Discussionmentioning

confidence: 94%

“…[8] It is advocated that early repair aids in ensuring periorbital stability, achieving infection control, increasing the circulation of tissues by decompression and preventing fibrosis and atrophy of the orbital soft tissue. [2,8,9] Although the results of a recent meta-analysis suggest that early repair is beneficial due to a multifactorial improvement, [10] the level of evidence of studies supporting early repair is low. In our study, most of the patients were operated in a relatively late period, however, inconsistent with the literature, [2,8,9] we did not encounter a high rate of complications in the postoperative period.…”

Section: Discussionmentioning

confidence: 99%

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Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Özkaya

Erçöçen

2020

ENT Updates

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Objective: The porous polyethylene implant (PPEI) is one of the most commonly used alloplastic materials in cranio-maxillofacial surgery. It is widely preferred because of its biocompatible, durable, flexible and thin nature as well as for its low complication rates. The purpose of the present study was to review the clinical and surgical outcomes of PPEI usage for orbital floor fractures. Methods: The present study included 76 patients who underwent orbital floor fracture reconstruction using PPEI between July 2000 and July 2018. All demographic characteristics of the patients were recorded and the patients were questioned and/or examined whether there was any complaint or complication secondary to the surgery. Results: The mean age of the patients was 35.2 years with a male predominance. The most common causes of injury were in-vehicle traffic accidents, falls, physical assaults and pedestrian accidents, respectively. 73 patients had other concomitant fractures of the facial bones along with the orbital floor fracture. The mean time between the injury and the surgical repair was eight days. Scleral show was observed in two patients (2.6%) due to scar contracture of the subciliary incision whereas one patient had surgical removal of the PPEI. Conclusion: The present study revealed that PPEI is a reliable and flexible material for the reconstruction of orbital floor fractures with a low risk of complications. To prevent or minimize postoperative complications, the orbital septum must be repaired meticulously.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Özkaya

Erçöçen

2020

ENT Updates

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“…La complicación más común asociada al uso de estos abordajes corresponde a la malposición palpebral inferior, pudiendo observarse como ectropión o eversión palpebral, entropión o inversión palpebral, exposición escleral, entre otras (2,4,5) .…”

Section: Problemaunclassified

“…Encontramos seis revisiones sistemáticas (2,3,4,5,6,7) que incluyeron 17 estudios primarios (8,9,10,11,12,13,14,15,16,17,18,19,20,21,22,23,24) , de los cuales, cuatro son ensayos aleatorizados (13,14,21,23) .…”

Section: Acerca Del Conjunto De Evidencia Para Esta Preguntaunclassified

“…• Las conclusiones de este resumen coinciden en general con las de las revisiones identificadas respecto al riesgo de desarrollar ectropión, entropión y resultados estéticos insatisfactorios. Sin embargo, difieren al evaluar el desenlace otras complicaciones intra y post operatorias, dado que ellas concluyen que no existirían diferencias entre los abordajes (4,5,6) .…”

Section: Diferencias Entre Este Resumen Y Otras Fuentesunclassified

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Abordaje transconjuntival en comparación con abordaje subciliar para el tratamiento de fracturas orbitarias

Vargas-Buratovic

Uribe-Monasterio

Ortuño

et al. 2020

Int. j interdiscip. dent.

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Introducción: Los abordajes transconjuntival preseptal y subciliar han sido ampliamente utilizados para el manejo quirúrgico de las fracturas orbitarias. Sin embargo, aún existe incertidumbre sobre las complicaciones asociadas a cada uno de estos abordajes. Métodos: Realizamos una búsqueda en Epistemonikos, la mayor base de datos de revisiones sistemáticas en salud, la cual es mantenida mediante el cribado de múltiples fuentes de información, incluyendo MEDLINE, EMBASE, Cochrane, entre otras. Extrajimos los datos desde las revisiones identificadas, analizamos los datos de los estudios primarios. Realizamos un metanálisis y preparamos una tabla de resumen de los resultados utilizando el método GRADE. Resultados y conclusiones: Identificamos seis revisiones sistemáticas que en conjunto incluyeron 21 estudios primarios, de los cuales cuatro corresponden a ensayos aleatorizados. Concluimos que el abordaje transconjuntival preseptal podría disminuir tanto la incidencia de ectropión como de un resultado estético insatisfactorio, pero la certeza de la evidencia es baja. Además, este abordaje probablemente disminuye el riesgo de complicaciones intra y postoperatorias, tales como diplopía, parestesia transitoria, equimosis, exposición escleral, laceración del plato tarsal y laceración palpebral inferior. Por otro lado, el abordaje transconjuntival podría aumentar el riesgo de entropión, pero la certeza de la evidencia también es baja.

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Anatomy of the Orbit: Overall Aspects of the Peri- and Intra Orbital Soft Tissues

Gooris,

Cornelius

2023

Surgery in and Around the Orbit

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Soft tissue systems in and around the orbit are presented in detail. The complexity of the soft tissue structures and its topographical location provides optimal environment for the delicate globe and supportive elements.Anatomic aspects and the protective and physiological function of the eyelids are described. The secretory lacrimal system and the spread of aqueous fluid along the globe and final drainage will be discussed. Anatomical features of the globe and the accompanying extraocular musculature are highlighted. The involved musculature allows for a most efficient guarantee of function and protection. Participating fat compartments provide a cushion and play a gliding role. The control via the neuro-ophthalmologic pathways, motor-, sensory-, and autonomic innervation is the essential base for the function of the eye.

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What surgical approach has the lowest risk of the lower lid complications in the treatment of orbital floor and periorbital fractures? A frequentist network meta-analysis

Cited by 26 publications

References 60 publications

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Reconstruction of orbital floor fractures using a porous polyethylene implant: outcomes in the early, intermediate and late postoperative periods

Abordaje transconjuntival en comparación con abordaje subciliar para el tratamiento de fracturas orbitarias

Anatomy of the Orbit: Overall Aspects of the Peri- and Intra Orbital Soft Tissues

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