• Journal of Korean Neurosurgical Society
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• 제44권3호
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• pp.156-158
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• 2008

Intraorbital hemorrhage is a rare clinical condition caused by orbital trauma, surgery around the orbit, intraorbital vascular abnormalities, and neoplasm. It was reported to occur spontaneously without any known causes and in association with orbital pseudotumor in a very few cases. A 59-year-old, female patient admitted with sudden onset of severe exophthalmos and pain on the left eye. Orbital CT and MR imaging suggested hemorrhage in the upper part of retrobulbar area of the left orbit. Cerebral angiography was taken to rule out any possible vascular abnormalities. On the left carotid cerebral angiography, the run-off of the distal ophthalmic artery was not seen and the engorgement of the supraophthalmic artery was noted. Systemic administration of corticosteroid did not improve the clinical status and craniectomy was done and retrobulbar hematoma was removed, and the clinical symptoms and signs were improved. Authors report a case of spontaneous intraorbital hemorrhage with the clinical features similar to those of orbital pseudotumor, requiring surgical decompression.

• 대한두개안면성형외과학회지
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• 제22권2호
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• pp.110-114
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• 2021

Retrobulbar hemorrhage is a disastrous condition that can lead to permanent blindness. As such, rapid diagnosis and treatment are critical. Here, we report a patient who presented with retrobulbar hemorrhage following an orbital floor fracture. Restoration of inferior orbital wall with porous polyethylene implant was underwent. Four days after the orbital floor reconstruction, the patient smoked a cigarette outdoors in -3℃ weather. Cold temperature and smoking caused an increase in his systemic blood pressure. The elevated blood pressure increased intraorbital pressure to the extent of causing central retinal artery occlusion and exacerbated oozing. During exploratory surgery, 3 mL of hematoma and diffuse oozing without arterial bleeding were observed. Prompt diagnosis and treatment prevented vision impairment. Few studies have reported on the risk factors for retrobulbar hemorrhage. This case showed that daily activities, such as exposure to cold weather or tobacco smoking, could be risk factors for retrobulbar hemorrhage.

• 대한두개안면성형외과학회지
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• 제10권1호
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• pp.29-32
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• 2009

Purpose: Alloplastic implants, such as $Silastic^{(R)}$, $Supramid^{(R)}$, Porous polyethylene, $Teflon^{(R)}$ have been used to prevent reherniation of orbital tissue and are known to be inert for many years, though complications are infrequently reported many years after their insertion. Complications associated with implants are infrequent, but infection, orbital hemorrhage, implant extrusion, motility restriction, migration of implant causing dacryocystitis, cystic formation have been described. The latter was known as a rare late complication of blow-out fracture repair. Methods: We report the case of a discovery of a intraorbital hemorrhagic cyst which developed after silicon implant insertion. This patient developed diplopia, unilateral proptosis, exophthalmos, vertical dystopia, ectropion 10 years after repair of blow-out fracture. In this case, orbital CT scan revealed intraorbital cyst surrounding the orbital implant. At surgery, a fibrous capsule surrounded the silicon implant and was filled with mucin pools. Results: Proptosis, diplopia, exophthalmos, ectropion, vertical dystopia were resolved after surgical removal of the cyst and implant. Conclusion: This case illustrate that it is important for us to be aware of the complication of cyst formation around the silicon implants.

• 대한두개안면성형외과학회지
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• 제18권2호
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• pp.137-140
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• 2017

Alloplastic materials used for orbital fracture reconstruction can induce complications, such as infection, migration, extrusion, intraorbital hemorrhage, and residual diplopia. Silicone is one of the alloplastic materials that has been widely used for decades. The author reports a rare case of spontaneous extrusion of a silicone implant that was used for orbital fracture reconstruction 30 years earlier. A 50-year-old man was admitted to the emergency room for an exposed substance in the lower eyelid area of the left eye, which began as a palpable hard nodule a week earlier. The exposed material was considered to be implant used for previous surgery. Under general anesthesia, the implant and parts of the fibrous capsule tissue were removed. Several factors hinder the diagnosis of implant extrusions that occur a long period after the surgery. So, surgeons must be aware that complications with implants can still arise several decades following orbital fracture reconstruction, even without specific causes.

• Archives of Plastic Surgery
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• 제40권6호
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• pp.721-727
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• 2013

Background One of the main concerns in orbital blowout fracture repair is a narrow operation field, due mainly to the innate complex three dimensions of the orbit; however, a deep location and extensive area of the fracture and soft tissue edema can also cause concern. Swelling of the orbital contents progresses as the operation continues. Mannitol has been used empirically in glaucoma, cerebral hemorrhage, and orbital compartment syndrome for decompression. The authors adopted mannitol for the control of intraorbital edema and pressure in orbital blowout fracture repair. Methods This prospective study included 108 consecutive patients who were treated for a pure blowout fracture from January 2007 to October 2012. For group I, mannitol was administered during the operation. Under general anesthesia, all patients underwent surgery by open reduction and insertion of an absorbable mesh implant. The authors compared postoperative complications, the reoperation rate, operation time, and surgical field improvement between the two groups. Results In patients who received intraoperative administration of mannitol, the reoperation rate and operation time were decreased; however, the difference was not statistically significant. The total postoperative complication rates did not differ. Panel assessment for the intraoperative surgical field video recordings showed significantly improved vision in group I. Conclusions For six years, mannitol proved itself an effective, reliable, and safe adjunctive drug in the repair of orbital blowout fractures. With its rapid onset and short duration of action, mannitol could be one of the best methods for obtaining a wider surgical field in blowout fracture defects.