• Archives of Plastic Surgery
• /
• v.34 no.6
• /
• pp.729-734
• /
• 2007

Purpose: The operative treatment for blow-out fracture involves restoration of intra-orbital soft tissue and bony structural integrity. There are several methods for reconstruction of inferior blow out fracture. We report reduction of inferior blow-out fracture with urinary balloon catheter in comparison with $Medpor^{(R)}$ using group to complication rate. Methods: A retrospective study was performed on 67 patients who underwent inferior orbital blow-out fracture reconstruction with $Medpor^{(R)}$ implant or urinary balloon catheter following between 2003 and 2006. Hospital records were reviewed especially for preoperative and postoperative enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia between $Medpor^{(R)}$ implant group and balloon catheter using group. Results: There was no significant statistical difference between both groups on incidence of postoperative complications of enophthalmos, diplopia, extraocular muscle movement limitations, and hypoesthesia. Postoperative infection, ectropion were absent in both groups.Conclusion: The use of urinary balloon catheter is simple, fast and inexpensive. Urinary balloon catheter is an alternative and reliable use for reduction of inferior orbital blow-out fracture.

• Proceedings of the KSRS Conference
• /
• 2004.10a
• /
• pp.205-207
• /
• 2004

The simple method of the geometric reconstruction of satellite linear pushbroom images is investigated. The model of the sensor used is based on the SPOT model that is developed by Kraiky. The satellite trajectory is a Keplerian trajectory in the approximation. Four orbital parameters, longitude of the ascending $node(\omega),$ inclination of the orbit plan(I), latitude argument of the satellite(W) and distance between earth center and satellite, are used for the camera modeling. We suppose that four orbital parameters and satellite attitude angles are exactly acquired. Then, in order to refine model, the given attitude angles and orbital parameters is not changed, but time-independent four parameters associated with LOS(Line Of Sight) vector is updated. A pair of SPOT-5 images has been used for validation of proposed method. Two GCPs acquired by GPS survey is used to controlling the LOS vector. The results are that the RMSE of 16 checking points are about 4.5m. Because the ground resolution of SPOT-5 is 2.5m, the result obtained in this study has a good accuracy. It demonstrates that the sensor model developed by this study can be used to reconstruct the geometry of satellite image taken by pushbroom camera.

• Archives of Plastic Surgery
• /
• v.39 no.1
• /
• pp.11-17
• /
• 2012

Management of posttraumatic enophthalmos can present as a challenge to the reconstructive surgeon, particularly in cases of late presentation. This article reviews the pertinent anatomy of the orbit, diagnostic modalities, indications for surgery, and surgical approaches as they relate to the treatment of posttraumatic enophthalmos. Internal orbital reconstruction has evolved to an elegant procedure incorporating various biologic or alloplastic implants, including anatomical pre-bent implants. Successful repair of late enophthalmos has been demonstrated in multiple recent studies and is likely related to the precision with which orbital anatomy can be restored.

• Archives of Craniofacial Surgery
• /
• v.21 no.4
• /
• pp.219-224
• /
• 2020

Background: Repair of the orbital floor following trauma or tumor removal remains a challenge because of its complex three-dimensional shape. The purpose of the present study is to understand normal orbital floor anatomy by investigating its differences across four groups (Caucasian American and East Asian, males and females) via facial bone computed tomography (CT). Methods: A total of 48 orbits in 24 patients between 20 and 60 years of age were evaluated. Although most patients underwent CT scanning following trauma, the orbital walls were intact in all patients. Linear and angular measurements of the orbital floor were obtained from CT images. Results: Orbital floor width, length, angle between the orbital floor and medial wall, and distance from the inferior orbital rim to the lowest point of the orbital floor did not show a statistically significant difference between groups. Angles made by the infraorbital rim, the lowest point of the floor, and the anterior border of the infraorbital fissure were statistically significantly wider in East Asian females than in male groups. The floor depth in East Asian females was significantly smaller compared to all the other groups. Conclusion: East Asian female population had smaller curvature and depth of an orbital floor than the other groups, which means racial and sex-related differences should be considered in the orbital floor reconstruction.

• Journal of Korean Neurosurgical Society
• /
• v.30 no.1
• /
• pp.105-109
• /
• 2001

Lymphangioma is a rare benign developmental vascular tumor that may be found in orbit, skull and elsewhere in head and neck. Few cases of extension of this benign but insidious tumor posteriorly out of the bony orbital cavity have been reported. The patient was 40-year-old man complaining of proptosis of right eye for one month. Physical examination revealed severe right exophthalmus, impairment of eyeball movement in all directions. Visual acuity was much impaired and he could percept only light with right eye. CT and MRI scans showed intraconal and extraconal involvement of ill-defined, heterogenous mass with extension of the tumor posteriorly beyond the orbital cavity involving right frontal and temporal lobe, skull and subcutaneous tissue. The tumor was subtotally removed via orbito-frontal approach without damaging vital neural and orbital component. Then, orbital roof reconstruction and cranioplasty were done with resin. Successful surgical removal of lymphangioma is very difficult due to its severe infiltration to surrounding tissue and tendency to bleed during debulking. We report a rare case of orbital cavernous lymphangioma with intracranial extension treated with surgical decompression, with review of literatures.

• Archives of Plastic Surgery
• /
• v.37 no.5
• /
• pp.633-638
• /
• 2010

Purpose: Orbital bone is one of the most complex bones in the human body. When the patient has a fracture of the orbital bone, it is difficult for the surgeon to restore the fractured orbital bone to normal anatomic curvature because the orbital bone has complex curvature. We developed a rapid prototyping model based on a mirror image of the patient's 3D-CT (3 dimensional computed tomography) for accurate reduction of the fractured orbital wall. Methods: A total of 7 cases of large orbital wall fracture recieved absorbable plate prefabrication using rapid prototyping model during surgery and had the manufactured plate inserted in the fracture site. Results: There was no significant postoperative complication. One patient had persistent diplopia, but it was resolved completely after 5 weeks. Enophthalmos was improved in all patients. Conclusion: With long term follow-up, this new method of orbital wall reduction proved to be accurate, efficient and cost-effective, and we recommend this method for difficult large orbital wall fracture operations.

• Archives of Plastic Surgery
• /
• v.38 no.6
• /
• pp.783-790
• /
• 2011

Purpose: The zygoma (Zygomaticomaxillary) complexes make up a large portion of the orbital floor and lateral orbital walls. Zygoma fracture frequently causes the posteromedial displacement of bone fragments, and the collapse or overlapping of internal orbital walls. This process consequently can lead to the orbital volume change. The reduction of zygoma in an anterolateral direction may influence on the potential bone defect area of the internal orbital walls. Thus we performed the quantitative analysis of orbital volume change in zygoma fracture before and after operation. Methods: We conducted a retrospective study of preoperative and postoperative three-dimensional computed tomography scans in 39 patients with zygoma fractures who had not carried out orbital wall reconstruction. Orbital volume measurement was obtained through Aquarius Ver. 4.3.6 program and we compared the orbital volume change of injured orbit with that of the normal contralateral orbit. Results: The average orbital volume of normal orbit was 19.68 $cm^3$. Before the operation, the average orbital volume of injured orbit was 18.42 $cm^3$. The difference of the orbital volume between the injured orbit and the normal orbit was 1.18 $cm^3$ (6.01%) on average. After operation, the average orbital volume of injured orbit was 20.81 $cm^3$. The difference of the orbital volume between the injured orbit and the normal orbit was 1.17 $cm^3$ (5.92%) on average. Conclusion: There are considerable volume changes in zygoma fracture which did not accompany internal orbital wall fracture before and after operation. Our study reflects the change of bony frame, also that of all parts of the orbital wall, in addition to the bony defect area of orbital floor, in an isolated zygoma fracture so that it evaluates orbital volume change more accurately. Thus, the measurement of orbital volume in isolated zygoma fractures helps predict the degree of enophthalmos and decide a surgical plan.

• Archives of Craniofacial Surgery
• /
• v.22 no.6
• /
• pp.310-318
• /
• 2021

Background: Transcutaneous lower eyelid approaches are associated with a risk of postoperative scarring depending on the distance between the incision line and the lower eyelid margin. The lower eyelid crease of Caucasians corresponds to a ridge-shaped fold in young Asians. However, this relationship has not been sufficiently evaluated in the latter. The authors, therefore, investigated the location of the scar and the lower eyelid crease or ridge to find the optimal location for the incision line. Methods: This study included 60 out of 139 patients who underwent inferior orbital wall reconstruction through a lower eyelid skin incision between July 2019 and June 2020. According to the location of the scar, the patients were classified into three groups: group A (≥ 2 mm above the lower eyelid crease or ridge), group B (within the lower eyelid crease or ridge to 2 mm above the lower eyelid crease or ridge), and group C (within the lower eyelid crease or ridge to 2 mm below the lower eyelid crease or ridge). At 6 or 12 months after surgery, the Patient and Observer Scar Assessment Scale (POSAS) score was obtained, the distance between the lower eyelid margin and the scar (DMS) and the distance between the margins of the peripheral pupil and the lower eyelid (DMPE) were measured, and the occurrence of ectropion was evaluated. Results: Group B had the lowest POSAS score (A: 22.7 ± 8.0, B: 20.9 ± 2.4, C: 32.5 ± 4.1, p< 0.001). Linear regression analysis showed that the DMS was positively correlated with the POSAS score (p< 0.001) and that the risk of DMPE widening increased as the DMS decreased (p= 0.029). None of the patients had ectropion. Conclusion: When using the transcutaneous approach for inferior orbital wall reconstruction, the optimal incision site is within the lower eyelid crease or ridge to 2 mm above the lower eyelid crease or ridge.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
• /
• v.37 no.6
• /
• pp.524-529
• /
• 2011

Orbital roof and supraorbital ridge fractures are frequently associated with high energy concomitant craniofacial trauma. When a displacement of the orbital roof and supraorbital rim occurs, exploration, stabilization and reconstruction are warranted to limit the ocular complications. The management of fractures involving the frontal sinus must consider the possible need for obliteration or cranialization of the sinus. Many incisions have been described and used to approach these fractures, such as a coronal incision, eyebrow incision, and an incision through the laceration. We report 3 cases of orbital roof and supraorbital ridge fracture patients with a review of the relevant literature.

• Archives of Craniofacial Surgery
• /
• v.18 no.3
• /
• pp.197-201
• /
• 2017

Maxillary sinus mucocele can occur due to many medical factors such as chronic infection, allergic sinonasal disease, trauma, and previous surgery. However, it occurs mainly after Caldwell-Luc operation, usually more than 10 years after surgery. There are a few cases of maxillary sinus mucocele with ocular symptoms. Also, a case causing ocular symptoms because of invasion to the orbital floor is rare. Therefore, we report a case of a 55-year-old male patient who underwent Caldwell-Luc operation about 30 years ago. Then, symptoms such as exophthalmos, diplopia, and visual disturbance developed suddenly 3 months prior to admission. Computed tomography showed a cyst invading the orbital floor which resulted in eyeball deviation. The orbital floor defect measured approximately $2.5{\times}3.3cm$. Maxillary sinus mucocele was removed through an endoscopic approach. After this, we reconstructed the orbital floor through a subciliary incision. Observation was carried out after three years, and ocular symptoms such as diplopia and exophthalmos did not recur.