Long-Term Results of Orbital Roof Repair with Titanium Mesh in a Case of Traumatic Intraorbital Encephalocele: A Case Report and Review of Literature

Arslan, Erhan; Arslan, Selçuk; Kalkısım, Selçuk; Arslan, Ahmet; Kuzeylı, Kayhan

doi:10.1055/s-0036-1581064

Cited by 12 publications

(12 citation statements)

References 30 publications

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“…A total of 52 patients were included in the final analysis for the systematic review including the patient presented herein 3–5,7–38. These case reports ranged in date from 1951 to 2022 and included between 1 and 6 patients per report.…”

Section: Resultsmentioning

confidence: 99%

Natural History of Traumatic Encephaloceles: A Systematic Literature Review

Langman

Stopa

Cuoco

et al. 2022

Journal of Craniofacial Surgery

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Encephaloceles rarely develop following traumatic skull fractures. Given their low incidence, the clinical presentations and management strategies of these lesions are confined to case reports and limited case series. A systematic literature review was performed using PubMed, Ovid, and Web of Science databases to identify relevant articles using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A total of 37 articles met inclusion criteria, including the case presented herein. These articles reported 52 traumatic encephaloceles. Mean patient age was 25.3 years (range 6 mo-66 y) with a male predominance (63%, 33/52). The most common bony defects resulting in encephalocele formation were the orbital roof (52%, 27/52), ethmoid (35%, 18/52), and sphenoid (10%, 5/52). Mean time from traumatic injury to initial presentation was 21.3 months (range 0 d-36 y) with a bimodal distribution split between immediately following the traumatic injury (57%, 26/46) or in a delayed manner (43%, 20/46). Common presentations of orbital roof, frontonasal, and temporal bone encephaloceles were exophthalmos (85%, 23/27), cerebrospinal fluid rhinorrhea (71%, 17/24), and hearing loss (100%, 4/4), respectively. Operative approach, repair technique, and materials used for encephalocele reduction were highly variable. Surgical intervention afforded definitive symptomatic improvement or resolution in the majority of cases (89%, 42/47). Clinical outcomes did not differ between orbital, frontonasal, or temporal bone encephaloceles (P = 0.438). Traumatic encephaloceles are a rare entity with diverse presenting symptomatology dependent upon the location of fracture dehiscence. Surgical intervention affords symptomatic improvement in the majority of cases irrespective of encephalocele location, time to presentation, or operative approach.

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Section: Resultsmentioning

confidence: 99%

Natural History of Traumatic Encephaloceles: A Systematic Literature Review

Langman

Stopa

Cuoco

et al. 2022

Journal of Craniofacial Surgery

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“…Repairs are commonly performed for fractures following high-impact trauma using titanium plating or micromesh with screws to fixate the material as required, however bone and cartilage autografts may also be used [ 8 , 9 ]. Despite the commonly described approaches of utilizing titanium mesh or autografts, we found that using an irradiated homologous cadaveric rib cartilage graft negates the need for autologous harvest, which is associated with morbidities and pain.…”

Section: Discussionmentioning

confidence: 99%

A novel technique to repair orbital roof defects: irradiated homologous cadaveric rib (Tutoplast ®) graft in a recurrent frontal sinus ossifying fibroma

Acharya

Navaratnam

et al. 2022

Journal of Surgical Case Reports

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Ossifying fibroma in the fronto-ethmoidal sinuses is a rare, benign condition. In symptomatic cases, surgical excision is often undertaken and bony defects may be repaired using alloplastic grafts. We present a novel method of repairing an orbital roof defect using irradiated homologous cadaveric rib (Tutoplast ®) graft, overlaid with a pericranial flap. The patient made an excellent recovery, concluding that it is a viable and safe option with lower morbidity.

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“…Decompressive craniectomy (DC) is the main method for rapidly reducing intracranial pressure (ICP) in patients with ASDH [6], but acute encephalocele often occurs suddenly during DC surgery, leading to higher mortality and morbidity, in this study, we can found the mortality rate of observation group 73.91% was higher than the control group 13.04%. Previous studies have suggested that delayed traumatic intracranial hematoma (DTIH), post-traumatic acute diffuse brain swelling (PADBS) and intracranial venous reflux disorder are the main factors affecting the acute encephalocele during surgery [7]. In this paper, related preoperative clinical data and CT image information were used to assess the occurrence of intra-operative acute encephalocele, so as to provide a basis for the developent of a more scientific and reasonable treatment strategy for ASDH patients.…”

Section: Discussionmentioning

confidence: 99%

Preoperative Head CT Assisted Prediction of Acute Encephalocele During Isolated Acute Subdural Hematoma Surgery

Wu¹,

Wu²,

Tang³

et al. 2021

IJN

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To investigate more predictors for acute encephalocele in patients during isolated acute subdural hematoma (ASDH) surgery by using clinical data combined with preoperative cranial computed tomography (CT) scan, so as to provide a basis for the development of a more scientific and reasonable treatment strategy. CT images and medical records of 46 patients who underwent neurosurgery for isolated traumatic acute subdural hematoma were collected. The patients with intra-operative acute encephalocele were grouped as the observation group (n=23), and the patients with no intra-operative acute encephalocele, whose age difference was within 5 years were included in the control group (n=23). The t-test and multivariate logistic regression analyses were carried out to evaluate the influence of clinical variables on acute encephalocele. Meanwhile, whether differences among Thickness of hematoma(TH), Midline shift (MLS), Hounsfield units of white matter (HU-WM), Hounsfield units of hematoma (HU-HT) and basal cistern effaced score (CES) measured by cranial CT could be used as predictors of outcomes in patients with acute encephalocele during subdural hematoma surgery was evaluated. There were no significant differences in age, sex, mechanism of injury, the time from trauma to decompression, and the MLS during surgery between the two groups. However, significant differences in preoperative Glasgow Coma Score (GCS), TH, HU-WM and HU-HT between the two groups were observed. The multivariate logistic regression analysis of radiographic data showed that HU-WM and CES were independent risk factors and strong predictors for intra-operative acute encephalocele. The areas under curve of CES and HU-WM were 0.8459 and 0.8336, respectively. The risk factors for acute encephalocele during ASDH operation are identified in this study. An increased risk of intra-operative acute encephalocele is found in patients with lower preoperative GCS, HU-WM, HU-HT and higher preoperative TH and CES, which should help clinicians to develop a more scientific treatment strategy and improve the survival of such kind of patients.

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Long-Term Results of Orbital Roof Repair with Titanium Mesh in a Case of Traumatic Intraorbital Encephalocele: A Case Report and Review of Literature

Cited by 12 publications

References 30 publications

Natural History of Traumatic Encephaloceles: A Systematic Literature Review

Natural History of Traumatic Encephaloceles: A Systematic Literature Review

A novel technique to repair orbital roof defects: irradiated homologous cadaveric rib (Tutoplast ®) graft in a recurrent frontal sinus ossifying fibroma

Preoperative Head CT Assisted Prediction of Acute Encephalocele During Isolated Acute Subdural Hematoma Surgery

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