Complications Following Orbital Floor Repair: Impact of Intraoperative Computed Tomography Scan and Implant Material

Causbie, Jacqueline M.; Walters, Benjamin K; Lally, John W.; Adams, Jason; Aden, James K; Bevans, Scott E.; Spear, Samuel A.; Robitschek, Jon

doi:10.1089/fpsam.2020.0117

Cited by 8 publications

(7 citation statements)

References 24 publications

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Section: Diplopia Gaze Restriction Hypesthesiasmentioning

confidence: 99%

“…Once again, in an effort to reduce postoperative complications and confirm implant position, the use of intraoperative CT scan has been advocated. 16,24 Naso-orbitoethmoid Complex…”

Section: Enophthalmos and Hypoglobusmentioning

confidence: 99%

“…18 Initial postoperative diplopia (i.e., neurogenic diplopia) has been described to occur in up to 86% of patients; however, this reduces significantly as swelling reduces and healing progresses. 15,17,24 Generally, 3 months of watchful waiting should be given prior to proceeding with revision surgical intervention. 15 Postoperative diplopia and EOM restriction are reported to occur in 3.2 to 23.5% and 5.8 to 23.5% of patients, respectively, 17,19 with some evidence suggesting worsened outcomes for trapdoor fractures.…”

Section: Diplopia Gaze Restriction Hypesthesiasmentioning

confidence: 99%

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Evidence-Based Medicine for Midface/Orbit/Upper Facial Fracture Repair

2023

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The face is one of the most common areas of traumatic injury, making up approximately 25% of all injuries in 2016. Assault, motor vehicle collision (MVC), fall, sports, occupational, and gunshot wounds (GSW) are all common causes of facial fractures, with MVC and GSW leading to significantly higher severity of injuries. Most facial fractures occur in the upper two-thirds of the face. Most facial fractures require timely assessment, diagnosis, and treatment for optimal restoration of facial structures and functions. Without proper initial management, significant complications including immediate complications such as airway compromise, massive bleeding, infection, intracranial hemorrhages, or even death, and long-term complications such as poor functional outcomes and aesthetic setbacks can occur. The goal of this review is to summarize the management of fractures of the upper face, orbit, and midface and provide an update about complications and their management.

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Section: Diplopia Gaze Restriction Hypesthesiasmentioning

confidence: 99%

“…Once again, in an effort to reduce postoperative complications and confirm implant position, the use of intraoperative CT scan has been advocated. 16,24 Naso-orbitoethmoid Complex…”

Section: Enophthalmos and Hypoglobusmentioning

confidence: 99%

Section: Diplopia Gaze Restriction Hypesthesiasmentioning

confidence: 99%

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Evidence-Based Medicine for Midface/Orbit/Upper Facial Fracture Repair

2023

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“…Patients with preoperative entrapment are more at risk for post-reconstruction diplopia. 43 If a fracture of the orbital floor is not repaired, revision surgery with placement of an orbital implant is the treatment of choice. The main complications associated with the use of orbital implants are implant extrusion and displacement.…”

Section: Complicationsmentioning

confidence: 99%

Management of Posttraumatic Enophthalmos Including Complex Secondary Deficits

Gengler

Hsieh

2022

Facial Plast Surg

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Posttraumatic enophthalmos (PE) arises when the ocular globe is displaced posteriorly and inferiorly in the orbital cavity due to a mismatch in orbital volume and orbital content. This most commonly happens after orbital fractures. The resulting disruptions to aesthetic form and ocular functions often necessitate surgical correction for reconstruction and restoration. The purpose of surgical management of PE is to reconstruct orbital shape and volume as well as to restore any herniated orbital content. This can be particularly challenging in cases involving large defects that require complex orbital reconstruction. Recent advancements in computer-aided surgery have introduced innovative and important tools to assist surgeons with these difficult cases. The ability to create customized, patient-specific implants can facilitate reconstruction involving complicated anatomy. Additionally, intraoperative imaging and intraoperative navigation can serve as useful guides for surgeons to more accurately place implants, especially in cases with limited visualization, in order to achieve optimal outcomes.

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“…Immediate revision rates based on intraoperative imaging have been reported to be 15 to 31% and tend to be highest in orbital, zygomaticomaxillary, and naso-orbito-ethmoidal repairs. [27][28][29] Postoperative outcomes such as diplopia following orbital reconstruction and need for revision surgery have been shown to be significantly improved by the use of intraoperative CT. [29][30][31] Interestingly, in the repair of isolated unilateral zygomaticomaxillary complex fractures, intraoperative CT has even been found to facilitate repair such that malar symmetry in repaired patients is no different than in patients with no trauma history. 32 The safety of intraoperative CT has also improved in recent years, as advances in imaging modalities such as improved resolution of cone beam CT have enabled detailed intraoperative imaging with reductions in radiation dose, minimal increases in operative time, and subsequent exposure to general anesthetic.…”

Section: Imaging Modalitiesmentioning

confidence: 99%

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

et al. 2020

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The field of facial plastic and reconstructive surgery is privy to a myriad of technological advancements. As innovation in areas such as imaging, computer applications, and biomaterials progresses at breakneck speed, the potential for clinical application is endless. This review of recent progress in the implementation of new technologies in facial plastic surgery highlights some of the most innovative and impactful developments in the past few years of literature. Patient-specific surgical modeling has become the gold standard for oncologic and posttraumatic reconstructive surgery, with demonstrated improvements in operative times, restoration of anatomical structure, and patient satisfaction. Similarly, reductions in revision rates with improvements in learner technical proficiency have been noted with the use of patient-specific models in free flap reconstruction. In the cosmetic realm, simulation-based rhinoplasty implants have drastically reduced operative times while concurrently raising patient postoperative ratings of cosmetic appearance. Intraoperative imaging has also seen recent expansion in its adoption driven largely by reports of eradication of postoperative imaging and secondary—often complicated—revision reconstructions. A burgeoning area likely to deliver many advances in years to come is the integration of bioprinting into reconstructive surgery. Although yet to clearly make the translational leap, the implications of easily generatable induced pluripotent stem cells in replacing autologous, cadaveric, or synthetic tissues in surgical reconstruction are remarkable.

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Complications Following Orbital Floor Repair: Impact of Intraoperative Computed Tomography Scan and Implant Material

Cited by 8 publications

References 24 publications

Evidence-Based Medicine for Midface/Orbit/Upper Facial Fracture Repair

Evidence-Based Medicine for Midface/Orbit/Upper Facial Fracture Repair

Management of Posttraumatic Enophthalmos Including Complex Secondary Deficits

Implications of Applying New Technology in Cosmetic and Reconstructive Facial Plastic Surgery

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