2016
DOI: 10.5999/aps.2016.43.3.229
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Considerations for the Management of Medial Orbital Wall Blowout Fracture

Abstract: Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, i… Show more

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Cited by 32 publications
(29 citation statements)
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“…Since medial orbital wall fractures are often asymptomatic, they have received less attention in the literature [ 6 , 7 ]. However, they may cause complications such as diplopia, enophthalmos, and the entrapment of extraocular muscles [ 8 , 9 ]. In particular, enophthalmos may not appear immediately after the trauma because soft tissue swelling can last weeks or months.…”
Section: Discussionmentioning
confidence: 99%
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“…Since medial orbital wall fractures are often asymptomatic, they have received less attention in the literature [ 6 , 7 ]. However, they may cause complications such as diplopia, enophthalmos, and the entrapment of extraocular muscles [ 8 , 9 ]. In particular, enophthalmos may not appear immediately after the trauma because soft tissue swelling can last weeks or months.…”
Section: Discussionmentioning
confidence: 99%
“…The key to preventing such complications is not only to make an accurate diagnosis, but also to reconstruct the fractured wall of patients in whom surgery is indicated. CT scans enable more accurate diagnoses of orbital fractures, especially the medial wall type [ 8 , 10 ]. Surgical correction is generally necessary in patients with the following symptoms and signs: diplopia lasting over a week, limited EOM, blurred vision resulting from optic nerve compression, a bone deficit greater than 2 cm, or enophthalmos resulting from orbital tissue herniation [ 11 ].…”
Section: Discussionmentioning
confidence: 99%
“…Apesar de oferecer acesso direto e previsível à região orbitária medial e evitar lesões no aparelho lacrimal, observa-se que a técnica isolada possui limitado campo cirúrgico, o que dificulta grandes implantes. 9 Um estudo prospectivo realizado com 40 pacientes, com igual distribuição entre grupos, comparou os acessos transconjuntival com cantotomia lateral inferior, quando necessário, e o subciliar. A duração média entre as incisões até a exposição da fratura foi de 10-16 minutos na abordagem subciliar e 11-18 minutos na transconjuntival, o que não foi significativo.…”
Section: Na Abordagem Transcaruncular (Figura 5)unclassified
“…No entanto, ainda possuem alto custo, são necessárias incisões mais amplas e, se não cortadas corretamente, pode haver bordas irregulares que interferem em tecidos moles. 9 Figura 5: Inserção de folhas de Medpor ® por acesso transcaruncular (seta pontilhada). 7 A combinação dos acessos transconjuntival e transcaruncular possibilita uma melhor visualização cirúrgica para grandes fraturas orbitárias, já que a parede orbitária medial é acessada ao estender a incisão transconjuntival através da carúncula lacrimal, o que oferece melhor campo operacional para redução da fratura, posicionamento dos tecidos moles herniados e dos materiais para restauração.…”
Section: Na Abordagem Transcaruncular (Figura 5)unclassified
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