• Geomechanics and Engineering
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• v.12 no.3
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• pp.465-481
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• 2017

Thermal effect has great influence on wellbore stability in Dongfang 1-1 (DF 1-1) gas field, a reservoir with high-temperature and high-pressure. In order to analyze the wellbore stability in DF1-1 gas field, the variation of temperature field after drilling was analyzed. In addition, the effect of temperature changing on formation strength and the thermal expansion coefficients of formation were tested. On this basis, a wellbore stability model considering thermal effect was developed and the thermal effect on fracture pressure and collapse pressure was analyzed. One of the main challenges in this gas field is the decreasing temperature of the wellbore will reduce fracture pressure substantially, resulting in the drilling fluid leakage. If the drilling fluid density was reduced, kick or blowout may happen. Therefore, the key of safe drilling in DF1-1 gas field is to predict the fracture pressure accurately.

• Archives of Craniofacial Surgery
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• v.16 no.3
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• pp.114-118
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• 2015

Background: The reduction of orbital blowout fracture primarily aims to normalize the extra-ocular movement by returning the herniated orbital soft tissue into the original position, and to prevent enophthalmos by normalizing the orbital cavity volume. We introduce a balloon catheter-assisted orbital floor reduction technique. Methods: A retrospective review was performed for all patients with orbital floor fracture who underwent the technique described in the main body of this text. Medical records were reviewed for demographic data, clinical presentation and course, degree of enophthalmos, intraorbital volume on computed tomography scan, and postoperative outcomes. The enophthalmos and intraorbital volume of the injured site were compared to the uninjured eye and orbit. Results: The review identified 14 patients (11 male, 3 female). The mean preoperative difference in en-exopthalmos was 2.13 mm, while the mean orbital volume was 116%. The mean postoperative difference in en-exophthalmos had improved to 0.61 mm with a mean orbital volume of 101.85%. At the time of catheter removal at 10 days, three patients experienced diplopia (n=1), extra-ocular movement disorder (1), or enophthalmos (1). All of these had resolved by the 6-month follow-up visit. Conclusion: Balloon catheter-assisted reduction of the orbital floor fractures was associated with improvements in intraorbital volume and enopthalmos in the 14 patients. Notable complications included diplopia, enophthalmos, and limited extra-ocular movement, all of which were transient in the early postoperative period and had resolved by 6-month follow up.

• Archives of Plastic Surgery
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• v.39 no.6
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• pp.606-611
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• 2012

Background Facial fractures are infrequent in children and adolescents and have different clinical features from those in adults. The low incidence in children and adolescents reflects the flexibility and underdevelopment of their facial skeletons, as well as their more protected environments. Only a few reports have reviewed such patients in Korea. The authors performed a retrospective study to analyze the characteristics of facial fractures in the Korean pediatric population. Methods We conducted a retrospective review on a series of 741 patients, aged <18 years, with facial fractures who had been treated at our hospital between 2006 and 2010. The following parameters were evaluated: age, sex, cause, location and type of fractures, associated injuries, treatment and complications. Results A total of 741 consecutive patients met the inclusion criteria. The ratio of boys to girls was 5.7:1. Facial fractures most commonly occurred in patients between 13 and 15 years of age (36.3%). The most common causes of injury was violence. The nasal fracture was the most common type of fracture (69%) and the blowout fracture was the second most common (20%). Associated injuries occurred in 156 patients (21%). Conclusions The incidence of pediatric facial fractures caused by violence is high in Korea. Our results show that as age increases, etiological factors and fracture patterns gradually shift towards those found in adults. This study provides an overview of facial fractures in these age groups that helps illustrate the trends and characteristics of the fractures and may be helpful in further evaluation and management.

• Archives of Craniofacial Surgery
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• v.21 no.3
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• pp.156-160
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• 2020

Background: We have reported orbital wall restoration surgery with primary orbital wall fragment in pure blowout fractures using a combination of transorbital and transnasal approach in pure blow out fractures. However, this method was thought to be difficult to use for complex orbital wall fractures, since the sharp screw tip that fixate the maxillary wall increases the risk of balloon ruptures. In this study, we reviewed 23 cases of complex orbital fractures that underwent orbital wall restoration surgery with primary orbital wall fragment and evaluated the result. Methods: A retrospective review was conducted of 23 patients with complex orbital fracture who underwent orbital restoration surgery with primary orbital wall fragments between 2012 and 2019. The patients underwent orbital wall restoration surgery with primary orbital wall fragment with temporary balloon support. The surgical results were evaluated by the Naugle scale and a comparison of preoperative and postoperative orbital volume ratio. Complex fracture type, type of screw used for fixation and complications such as balloon rupture were also investigated. Results: There were 23 patients with complex orbital fracture that used transnasal balloon technique for restoration. 17 cases had a successful outcome with no complications, three patients had postoperative balloon rupture, two patients had soft-tissue infection, and one patient had balloon malposition. Conclusion: The orbital wall restoration technique with temporary balloon support can produce favorable results when done correctly even in complex orbital wall fracture. Seventeen cases had favorable results, six cases had postoperative complications thus additional procedure seems necessary to complement this method.

• Archives of Craniofacial Surgery
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• v.16 no.1
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• pp.35-38
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• 2015

Alloplastic implants have been used to repair orbital wall fractures in most cases. Orbital hemorrhage is a rare complication of these implants and has been reported rarely in Korea. The purpose of this article is to report a late complication case focusing on their etiology and management. A 20-year-old male patient underwent open reduction with Medpor (porous polyethylene) insertion for bilateral orbital floor fractures. The initial symptom occurred with proptosis in the right side as well as vertical dystopia, which had started 4 days earlier, 8 months after surgery. Any trauma history after the surgery was not present. We performed an exploration and removal of hematoma with Medpor titanium meshed alloplastic implant. A case of delayed orbital hematoma following alloplastic implant insertion was identified. It occurred within the pseudocapsule of the implant. One week after surgery, overall symptoms improved successfully, and no complications were reported during the 11-month follow-up period. Although rare, orbital hemorrhage is a potential complication of alloplastic orbital floor implants, which may present many years after surgery. As in the case presented, delayed hematoma should be included in the differential diagnosis of late proptosis or orbital dystopia.

• Archives of Plastic Surgery
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• v.34 no.6
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• pp.735-740
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• 2007

Purpose: Blowout fracture is an outward fracture of the orbital wall. That usually occurs at inferior or medial wall of the orbit. The main pathophysiology is high intraocular pressure derived from impact of trauma. Among the four orbital wall, the medial wall is thinnest and most vulnerable to trauma. Many kinds of methods were introduced for correction of medial orbital wall fracture. Recently, transnasal endoscopic reconstruction methods were widely used. Endoscopic methods had many advantages. However, we experienced some cases of postoperative maxillary sinusitis. This study was planned to find out the effectiveness of middle meatal antrostomy after endoscopic reconstruction of medial orbital wall fracture. Methods: This study was retrospective analysis of 28 patients who underwent transnasal endoscopic repair of medial orbital wall fracture. The 18 male and 10 female patients were ranged from 17 to 57 years of age(mean, 30.9 years). Among 28 patients, randomly selected 17 patients underwent middle meatal antrostomy as additional procedure by the same surgeon. After at least 12 months of follow-up period, we examined the nasal symptom, endoscopic and CT findings. Results: One patient complained of nasal obstruction in middle meatal antrostomy group and four patients complained nasal symptoms in non middle meatal antrostomy group. On the endoscopic findings, three patients of non middle meatal antrostomy group had continuous nasal discharge. But middle meatal antrostomy group had no abnormal endoscopic findings. The abnormal CT finding(abnormal mucosal hypertrophy) were detected in four patient of non middle meatal antrostomy group. There were no abnormal CT findings in middle meatal antrostomy group. The data were statistically significant at comparative study. Conclusion: Authors think that the middle meatal antrostomy has some advantages as a additional procedure of endoscopic reconstruction of medial orbital wall fracture. Especially, it is good at preventing postoperative maxillary sinusitis. But, more larger group and strict application of disease entity are need for correct evaluation of middle meatal antrostomy effect.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.486-492
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• 2014

Background We conducted this study to identify the correlation between the time to surgery and that to recovery from postoperative diplopia. Methods In the current single-center, retrospective study, we enrolled a total of 11 patients (n=11) who were diagnosed with white-eyed blowout fracture and underwent surgical operation at our institution between January 2009 and January 2013. To identify the correlation between the time to surgery and that to recovery from postoperative diplopia, we divided our patients into the three groups: the group A (time to surgery, <2 days) (n=4), the group B (time to surgery, 3-7 days) (n=4) and the group C (n=3) (time to surgery, 8-60 days). Then, we compared such variables as sex, age, signs of soft tissue injury, preoperative nausea/vomiting, the degree of preoperative diplopia and the side of the fracture on computed tomography scans between the three groups. Results In our series, mean age at the onset of trauma was nine years (range, 5-16 years); the mean time to surgery was 30 days (range, 2-60 days); and the mean follow-up period was one year (range, 6 months-2 years). Our results showed that the time to recovery was shorter in the patients with a shorter time to surgery. Conclusions We found that the degree of recovery from impaired ocular motility and diplopia was the highest in the patients undergoing surgical operations within 48 hours of the onset of trauma with the reconstruction of the fracture sites using implant materials.

• Archives of Craniofacial Surgery
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• v.19 no.4
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• pp.248-253
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• 2018

Background: The presence of enophthalmos is an important determinant in the decision of orbital wall fracture surgery. We proposed eyelid drooping as a new anthropometric diagnostic measure and analyzed whether eyelid drooping is associated with enophthalmos. Methods: This retrospective study was performed from January 2014 to December 2016. A total of 75 patients with blowout fractures were studied. One experimenter measured the degree of enophthalmos using a Hertel exophthalmometer at 1 week after trauma and at 3 months after surgery. The height change of the upper eyelid was measured using the marginal reflex distance (MRD) on both sides, and the degree of eyelid drooping was calculated by comparing the two lengths. We analyzed statistically the correlation between enophthalmos and eyelid drooping. Results: We found a highly significant correlation between the degree of enophthalmos and the reduction rate of MRD (RRM, as an indicator of eyelid drooping) at 1 week after trauma (r= 0.845). Approximately 2.0 mm of enophthalmos was associated with a 30.8% reduction in MRD on the affected side as compared with the normal side. At 3 months after surgery, patients showed improved eyelid appearance, with a moderate association between enophthalmos and RRM. Conclusion: We demonstrated that the degree of enophthalmos, measured using an exophthalmometer, is associated with a change in the height of the upper eyelid. Thus, upper eyelid drooping can be used as another indicator for orbital wall fracture surgery. Compared with conventional methods, measurements of eyelid drooping are easy to perform, offering a great advantage and understanding to the patient.

• Archives of Craniofacial Surgery
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• v.23 no.5
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• pp.228-231
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• 2022

Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery. A 65-year-old male patient presented with periorbital swelling and an open wound on the right infraorbital area. Computed tomography showed a right orbital floor fracture. After reduction of the herniated tissue into the orbit, an implant was inserted and fibrin glue was applied to stabilize the implant. This procedure was performed without difficulty, but the patient complained of persistent diplopia and limited eyeball movement after surgery. An imaging study showed a mass-like lesion, which was not a hematoma, in the orbital cavity. In a second operation, the mass was identified as clotted fibrin glue that had not been applied properly. After removal, the patient's symptoms were relieved without further complications. Appropriate and careful application of fibrin glue is necessary to avoid unnecessary complications.

• Archives of Craniofacial Surgery
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• v.14 no.1
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• pp.30-35
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• 2013

Background: For reconstruction of the mild to moderate medial orbital wall fractures, various surgical approaches have been used. Prior existing W-shaped incision was a direct local approach through a 3 cm incision on the superior medial orbital area with a titanium mesh implant. In this study, the authors modified W-shaped incision and reconstructed the defect with silastic sheet to improve the result and the postoperative scar. Methods: This study included 20 patients who had mild to moderate size of medial wall defect and therefore relatively suitable for reconstruction with silastic sheets from July, 2009 to December, 2011. A modified W-shaped skin incision approximately 1.2 to 1.5 cm in length was made along the superior medial orbital rim from approximately 1 cm medial to the medial canthus to the lower border of the medial eyebrow. The angles of the limbs of the W ranged from 150 to 160 degrees. Results: By using soft flexible silastic sheet, the authors reduced the incision from 3 to 1.5 cm, and by widening the angle of the W limbs, scars were more effectively hided in the relaxed skin tension line. Scar assessment was done with modified patient and observer scar assessment scale and mean score from patients was 2.08 and mean score from observers was 2.12. Conclusion: Although this method will not be suitable for every case, it can be a consistent method to obtain the surgical goal in treatment of mild to moderate blowout fractures of the medial orbital wall.