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Strabismus 2021 May 10:1-5. Epub 2021 May 10.

Department of Orthoptics, University of Liverpool, Liverpool.

This review aims to develop an evidence-based pathway for isolated adult orbital blowout fractures. Evaluation of assessment methods, outcome measures, imaging modalities, and crucially, the optimal timing of surgical intervention was critically examined to develop a clinically applicable care pathway. A literature search was carried out using Scopus, PubMed and Web of Knowledge. Read More

J Maxillofac Oral Surg 2021 Jun 16;20(2):189-200. Epub 2020 Jul 16.

Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India.

Purpose: Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent advancements in the form of intraoperative imaging and navigation have led to an adequate assessment and correct reduction of these fractures minimizing chances of any revision surgery. The purpose of this study was to evaluate the advantage of intraoperative computerized tomography (CT) scan in the management of ZMO/isolated orbital complex fracture and further to develop a protocol for managing such fractures. Read More

Orbit 2021 Apr 27:1-4. Epub 2021 Apr 27.

Department of Ophthalmology, Johns Hopkins Wilmer Eye Institute, Baltimore, Maryland, USA.

A 61-year-old man underwent left medial wall and floor fracture repair with a Suprafoil® implant. He had postoperative orbital congestion and lower eyelid swelling that persisted for over seven weeks. Examination demonstrated hyperglobus with supraduction, infraduction, and adduction deficits. Read More

Cesk Slov Oftalmol 2021 ;77(1):45-48

Orbital fractures may be accompanied with severe damage of the eye bulb and other intraorbital tissues. Early clinical findings can be very mild, therefore it is vital to actively seek not only for any damage done to the soft tissues of the orbit, but also for extraorbital complications such as liquorrhea or meningitis. We report a relatively rare case of blow-in fracture of orbital roof in eleven years old boy. Read More

Ann Maxillofac Surg 2020 Jul-Dec;10(2):495-500. Epub 2020 Jul 2.

School of Dentistry, University Center of Patos de Minas, Patos de Minas, Minas Gerais, Brazil.

Trauma in the face region has a very varied etiology and can be associated with several important structures. Isolated fractures in the orbit region correspond to about 4 to 16% of all facial fractures and this incidence increases to 30 to 55% if we take into account fractures that expand to extraorbital regions. The present clinical report aims to describe the case of a male patient, 21-years-old, victim of a motorcycle accident with facial trauma and traumatic brain injury due to frontal collision. Read More

Br J Neurosurg 2021 Feb 28:1-5. Epub 2021 Feb 28.

Department of Neurosurgery and Brain Repair, University of South Florida Morsani College of Medicine, Tampa, FL, USA.

Purpose: Intraorbital encephalocele (OMEC) is a rare entity in adults, usually secondary to an orbital pathology or prior trauma, in particular orbital roof fractures. Treatment of the OMEC is warranted to alleviate the pulsating exophthalmos and prevent potential visual decline. OMEC and orbital roof fractures have been predominantly treated via a craniotomy with a reconstruction of the orbital roof using various implants. Read More

Am J Ophthalmol Case Rep 2021 Mar 23;21:101021. Epub 2021 Jan 23.

Duke University, Department of Ophthalmology, Durham, NC, USA.

Purpose: Traumatic injury to the optic chiasm is rare and most frequently caused by high-velocity head trauma. It classically results in bitemporal hemianopsia and often presents in conjunction with multiple other traumatic injuries, such as skull fractures and cerebrospinal fluid leaks. We present the case of a 40-year-old woman with pre-existing thyroid orbitopathy who struck her forehead after a fall from standing height. Read More

Atlas Oral Maxillofac Surg Clin North Am 2021 Mar 16;29(1):129-137. Epub 2020 Dec 16.

Klinik für Mund-, Kiefer- und Gesichtschirurgie, UniversitätsSpital Zürich, Frauenklinikstrasse 24, Zürich 8091, Switzerland.

Pediatr Neurosurg 2021 27;56(1):85-89. Epub 2021 Jan 27.

Department of Radiology, Dankook University Hospital, Dankook University College of Medicine, Cheonan, Republic of Korea,

Introduction: Traumatic oculomotor nerve injury is usually caused by severe head trauma and is generally associated with other neurological deficits such as basilar skull fracture, orbital injury, or subarachnoid hemorrhage. Isolated traumatic oculomotor nerve injury after minor head trauma and its MRI findings are rarely reported.

Case Presentation: We report a case of a 13-year-old girl with mydriasis, limited inferior and medial movement of the left eyeball, and left ptosis after a mild bump of the left forehead and eye into an electricity pole. Read More

Craniomaxillofac Trauma Reconstr 2020 Sep 19;13(3):205-210. Epub 2020 May 19.

Department of Oral and Maxillofacial Surgery, Sheffield Teaching Hospitals, Charles Clifford Dental Hospital, Wellesley Road, Sheffield, United Kingdom.

Introduction: Treatment to restore anatomy, function, and aesthetics after trauma should involve as little surgical insult as possible. As such, repeated procedures may suggest failed initial management. To date, no predictive factors for failure of primary surgery have been identified. Read More

Craniomaxillofac Trauma Reconstr 2020 Sep 8;13(3):192-197. Epub 2020 Apr 8.

Department of Surgery, University of Minnesota, Minneapolis, MN, USA.

Intraoperative imaging is becoming increasingly common in repair of facial fractures. Many institutions do not have access to intraoperative advanced 3D imaging but have the capability of obtaining plain radiographs intraoperatively. At institutions where advanced 3D imaging is available, scout radiographs are usually obtained prior to a complete scan. Read More

Craniomaxillofac Trauma Reconstr 2020 Sep 1;13(3):180-185. Epub 2020 May 1.

Department of Public Health Dentistry, SDM College of Dental Sciences and Hospital, Shri Dharmasthala Manjunatheshwara University, Dharwad, Karnataka, India.

Purpose: Exposing the orbital floor requires a surgical procedure that has its own challenges. Despite the meticulous clinical examination followed by sophisticated imaging modalities, orbital floor defects associated with zygomaticomaxillary complex (ZMC) fractures may evade diagnosis and appropriate management. If surgeons can decide about the need for orbital floor exploration in patients with ZMC fracture, the chance of a postoperative eyelid deformity can be prevented. Read More

Semin Plast Surg 2020 Nov 24;34(4):254-259. Epub 2020 Dec 24.

Department of Oral and Maxillofacial, College of Dentistry, Texas A&M Health Science Center, Dallas, Texas.

Zygomaticomaxillary (ZMC) fractures are the second most common facial fractures after nasal bone fractures. The zygoma, with its location and multiple points of articulations, lends itself to both facial structure and esthetics. Secondary ZMC deformities are complications of inadequate primary correction, delayed repair, or lack of repair. Read More

BMJ Case Rep 2020 Dec 22;13(12). Epub 2020 Dec 22.

Department of Ophthalmology, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Traumatic optic neuropathy is sinister sequelae of craniofacial trauma leading to vision loss. The decision between early medical or surgical intervention is usually individualised. Visual evoked potentials may guide the treatment plan. Read More

Plast Reconstr Surg 2021 01;147(1):162-166

From the Departments of Plastic Surgery and Radiology, University of Pittsburgh; the Division of Plastic and Reconstructive Surgery, University of Massachusetts Medical School-Baystate, Baystate Medical Center; and the Division of Otolaryngology, Yale School of Medicine.

Background: Orbital blowout fracture reconstruction often requires an implant, which must be shaped at the time of surgical intervention. This process is time-consuming and requires multiple placement trials, possibly risking complications. Three-dimensional printing technology has enabled health care facilities to generate custom anatomical models to which implants can be molded to precisely match orbital anatomy. Read More

Plast Reconstr Surg 2021 01;147(1):82e-93e

From the Division of Plastic, Reconstructive, and Maxillofacial Surgery, R Adams Cowley Shock Trauma Center; the Department of Plastic and Reconstructive Surgery, Johns Hopkins University; and the Division of Plastic and Reconstructive Surgery, University of Maryland School of Medicine.

Background: Fractures of the orbital roof require high-energy trauma and have been linked to high rates of neurologic and ocular complications. However, there is a paucity of literature exploring the association between injury, management, and visual prognosis.

Methods: The authors performed a 3-year retrospective review of orbital roof fracture admissions to a Level I trauma center. Read More

Int J Surg Case Rep 2021 Jan 11;78:172-175. Epub 2020 Dec 11.

Department of General Surgery, Ventura County Medical Center, Ventura, CA, USA.

Orbital roof fractures are among the rarest of craniofacial fractures. The mechanism of injury is typically a high-impact blunt force vector directly to the orbit or forehead. Most patients are males between 20 and 40 years old, involved in motor vehicle accidents. Read More

J Emerg Med 2021 Mar 7;60(3):377-379. Epub 2020 Dec 7.

Department of Ophthalmology, National Taiwan University Hospital, Taipei, Taiwan.

Background: Orbital compartment syndrome (OCS) is an ocular emergency that can severely threaten the visual potential. The most common etiologies include facial trauma-related orbital wall fractures and postoperative bleeding within the orbit. Nontraumatic cases were also reported sporadically, although they are rare. Read More

Head Face Med 2020 Nov 26;16(1):30. Epub 2020 Nov 26.

Discipline of Oral Surgery, 2nd Department of Dental Medicine, "Victor Babeş" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041, Timisoara, Romania.

Background: The pattern of zygomatic bone fractures varies in the literature, their features being frequently masked by the presence of associated soft tissue lesions. In this context the clinical diagnosis and the therapeutic indications can be difficult. The aim of this study was to evaluate the clinical features of zygomatic bone fractures and their interrelation with concomitant overlying soft tissue injuries, as well as to assess the type of treatment methods applied depending on the fracture pattern and the results achieved depending on the incidence rate of postoperative complications. Read More

J Oral Maxillofac Surg 2021 02 30;79(2):420-428. Epub 2020 Sep 30.

Professor, Department of Ophthalmology, Kyoto Prefectural University of Medicine, Kyoto, Japan.

Purpose: The purpose of this study is to report the outcomes of a series of orbital fracture repairs, their assessment with the Hess area ratio (HAR%), and the use of unsintered hydroxyapatite (HA) implants for reconstruction.

Methods: This study involved 207 consecutive unilateral orbital fractures with symptomatic diplopia that underwent surgical repair within 28 days of injury. Ocular movement was measured presurgery and at 3 and 6 months postsurgery by Hess chart with calculation of the HAR%. Read More

JAMA Ophthalmol 2021 01;139(1):77-83

Harvard Department of Ophthalmology, Massachusetts Eye and Ear, Boston.

Importance: Orbital fractures are common in ocular trauma, and there is a need to develop predictive tools to estimate risk of concurrent ocular injury.

Objective: To identify clinical and radiographic features that are associated with increased risk of substantial ocular injury in the setting of orbital fracture.

Design, Setting, And Participants: Retrospective consecutive case series of patients who sustained orbital fractures between 2012 and 2018. Read More

Ophthalmology 2020 12;127(12):1756

Department of Ophthalmology and Visual Sciences, Vanderbilt Eye Institute, Nashville, Tennessee.

J Craniofac Surg 2020 Nov/Dec;31(8):e769-e771

Department of Otorhinolaryngology-Head and Neck Surgery, Maryknoll Hospital, Busan, Republic of Korea.

The orbital complications of endoscopic sinus surgery, including diplopia and ocular motility restriction, are mainly caused by direct injury to the orbital structures. These complications are rare, but can have catastrophic consequences. Symptoms occur immediately after surgery in most cases. Read More

J Craniofac Surg 2020 Nov/Dec;31(8):2208-2212

Department of Ophthalmology, The Second Hospital of Dalian Medical University.

Open reduction followed by internal fixation (ORIF) has been regarded as the most effective technique for surgical repair of zygomaticomaxillary complex (ZMC) fractures. However, the ideal internal fixation method to achieve stable reduction remains controversial. This research aims to assess and compare the stability of the 2- and 3-point screw-plate fixation methods using finite element method (FEM). Read More

J Korean Assoc Oral Maxillofac Surg 2020 Oct;46(5):353-357

OMFS-IMPATH Research Group, Department of Imaging and Pathology, Faculty of Medicine, KU Leuven, Leuven, Belgium.

Fractures of the orbital floor and walls are among the most frequent maxillofacial fractures. Virtual three-dimensional (3D) planning and use of patientspecific implants (PSIs) could improve anatomic and functional outcomes in orbital reconstruction surgery. The presented case was a victim of a terrorist attack involving improvised explosive devices. Read More

J Oral Maxillofac Surg 2021 Jan 24;79(1):204.e1-204.e12. Epub 2020 Sep 24.

Attending, Oral and Maxillofacial Surgery Service, Hospital de Clínicas de Passo Fundo, Passo Fundo, Brazil.

Blunt trauma in the orbital region often results in fracture of 1 or more bone walls resulting in alteration of the orbital volume with the potential for visual sequelae. This study reports a rare case of displacement of the eyeball into the maxillary sinus after blunt trauma as well as its initial management, treatment, and clinical follow-up. Victims of eyeball displacement have a poor visual prognosis. Read More

Ann Palliat Med 2020 Sep;9(5):3710-3715

Department of Respiratory and Critical Care Medicine, Shanxi Medical University, Second Affiliated Hospital, Taiyuan, China.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a newly identified strain of coronavirus in the human body and was reported in Wuhan at the end of 2019. So far, the epidemic is continuing and very serious, with the number of infections and deaths increasing. Despite active investigations around the world to better understand the dynamics of transmission and the scope of clinical disease, COVID-19 continues to spread rapidly from person to person. Read More

Clin Ophthalmol 2020 24;14:2837-2842. Epub 2020 Sep 24.

Department of Ophthalmology, Loma Linda University Eye Institute, Loma Linda, CA, USA.

Purpose: The purpose of this study was to determine the incidence of minor and major ocular injuries in patients with orbital wall fractures at Loma Linda University Health, a level-one trauma center, to help determine the most appropriate setting for the initial dilated fundus examination by ophthalmologists.

Methods: A retrospective study was performed from January 2008 to January 2013 of patients diagnosed with orbital wall fracture secondary to trauma. Exclusion criteria included unknown mechanism of injury, the absence of ophthalmology consultation, or absence of imaging. Read More

J Craniofac Surg 2020 Oct 12. Epub 2020 Oct 12.

Department of Plastic Surgery, Department of Biomedical Informatics, Center for Biomedical Ethics and Society, Vanderbilt University Medical Center, Nashville, TN.

Introduction: Radiographic assessment of facial fractures with computed tomography (CT) scanning has become standard of care. As imaging resolution has improved, findings such as herniation of extraocular muscles (EOM) have become a means of diagnosing conditions like orbital entrapment. However, the sensitivity and specificity of these findings has not been well-studied. Read More

Semin Musculoskelet Radiol 2020 Oct 9;24(5):579-590. Epub 2020 Oct 9.

Department of Radiology, GZA Hospitals, Antwerp, Belgium.

Dental and facial trauma are very common in a daily routine radiology practice. Knowledge of the functional anatomy of the mandibulofacial and maxillofacial regions forms the cornerstone of a thorough full radiologic evaluation of the patient with a dental and/or facial trauma. Cone beam computed tomography and multidetector computed tomography are currently considered the imaging modalities of choice. Read More