Management of old naso-orbital fractures with ocular involvement and associated complications caused by facial trauma
DOI:
https://doi.org/10.13181/mji.v27i1.1959Keywords:
facial trauma, management, naso-orbital fracture, ocular complicationsAbstract
A 14-years-old boy came with chief complaint of epiphora and history of globe rupture repair surgery due to facial trauma one year ago. Patient got complications from the trauma, including nasolacrimal duct obstruction, phthisis bulbi, enophthalmos, facial deformities, and ptosis. Multidisciplinary approach was performed simultaneously in one session surgery which included oral mucosal graft for non-irritative phthisis bulbi, silicone block implant for blowout fracture, external dacrycystorhinostomy for obstructed nasolacrimal duct, fascia lata brow suspension/frontalis sling for ptosis, and septorhinoplasty for nasal augmentation. After the surgery, symptoms of epiphora had resolved and aesthetical improvement of facial deformities was also prominent. Management of old orbital fracture poses additional challenges due to the complications that have occurred over time. Loss of functionality may seem impractical to manage because no function can be pertained. Nevertheless, it is important to still perform surgical repair for aesthetic purposes due to the psychological effect on their daily lives.Downloads
References
Magarakis M, Mundinger GS, Kelamis JA, Dorafshar AH, Bojovic B, Rodriguez ED. Ocular injury, visual impairment, and blindness associated with facial fractures: a systematic literature review. Plast Reconstr Surg. 2012;129(1):227–33. https://doi.org/10.1097/PRS.0b013e3182362a6d
Myga-Porosilo J, Skrzelewski S, Sraga W, Borowiak H, Jackowska Z, Kluczewska E. CT imaging of facial trauma. Role of different types of reconstruction. Part I - Bones. Pol J Radiol. 2011;76(1):41–51.
Chen C-T, Chen Y-R. Update on orbital reconstruction. Curr Opin Otolaryngol Head Neck Surg. 2010;18(4):311–6. https://doi.org/10.1097/MOO.0b013e32833aafd2
Roth FS, Koshy JC, Goldberg JS, Soparkar CNS. Pearls of orbital trauma management. Semin Plast Surg. 2010;24(4):398–410. https://doi.org/10.1055/s-0030-1269769
Dunkin JM, Crum AV, Swanger RS, Bokhari SA. Globe trauma. Semin ultrasound CT MR. 2011;32(1):51–6. https://doi.org/10.1053/j.sult.2010.09.003
Cole P, Kaufman Y, Hollier L. Principles of facial trauma: orbital fracture management. J Craniofac Surg. 2009;20(1):101–4. https://doi.org/10.1097/SCS.0b013e318190e1b6
Nguyen M, Koshy JC, Hollier LH. Pearls of nasoorbitoethmoid trauma management. Semin Plast Surg. 2012;24(4):383–8. https://doi.org/10.1055/s-0030-1269767
Thakkar P, Patel JR, Sethuraman R, Nirmal N. Custom ocular prosthesis: a palliative approach. Indian J Palliat Care. 2012;18(1):78–83. https://doi.org/10.4103/0973-1075.97480
Girotto JA, MacKenzie E, Fowler C, Redett R, Robertson B, Manson PN. Long-term physical impairment and functional outcomes after complex facial fractures. Plast Reconstr Surg. 2001;108:312–27. https://doi.org/10.1097/00006534-200108000-00005
Cole P, Boyd V, Banerji S, Hollier LH Jr. Comprehensive management of orbital fractures. Plast Reconstr Surg. 2007;120 (Suppl. 2):57S–63S. https://doi.org/10.1097/01.prs.0000260752.20481.b4
Lindsey JL, Hamill MB. Scleral and corneoscleral injuries. In: Kuhn F, Pieramici DJ, editors. Ocular Trauma Principles and Practice. New York: Thieme; 2002. p. 111–22.
Schmack I, Volcker HE, Grossniklaus HE. Phthisis bulbi. In: Levin LA, Albert DM, editors. Ocular Disease Mechanism and Management. USA: Saunders Elsevier 2010. p. 415–23. https://doi.org/10.1016/B978-0-7020-2983-7.00054-1
Ma'luf RN, Awwad ST. Mucous membrane graft versus gunderson conjunctival flap for fitting a scleral shell over a sensitive cornea. Ophthal Plast Reconstr Surg. 2005;21(5):356–8. https://doi.org/10.1097/01.iop.0000175058.93880.91
Mai C, Bertelmann E. Oral Mucosal Graft: Old technique in new light. Ophthalmic Res. 2013;50(2):91–8. https://doi.org/10.1159/000351631
Aggarwal H, Singh RD, Kumar P, Gupta SK, Alvi HA. Prosthetic Guidelines for ocular rehabilitation in patients with phtisis bulbi: a treatment-based classification system. J Prosthet Dent. 2014;111(6):525–8. https://doi.org/10.1016/j.prosdent.2013.08.013
Burnstine M. Clinical recommendations for repair isolated orbital floor fractures: an evidence-based analysis. Ophthalmology. 2002;109(7):1207–10. https://doi.org/10.1016/S0161-6420(02)01057-6
Rinna C, Ungari C, Saltarel A, Cassoni A, Reale G. Orbital floor restoration. J Craniofac Surg. 2005;16(6):968–72. https://doi.org/10.1097/01.scs.0000186308.16795.8b
Prowse SJ, Hold PM, Gilmour RF, Pratap U, Mah E, Kimble FW. Orbital floor reconstruction: a case for silicone. A 12 years experience. J Plast Reconstr Aesthet Surg. 2010;63(7):1105–9. https://doi.org/10.1016/j.bjps.2009.05.057
Ali MJ, Gupta H, Honavar SG, Naik MN. Acquired nasolacrimal duct obstructions secondary to naso-orbito-ethmoidal fractures: patterns and outcomes. Ophthal Plast Reconstr Surg. 2012;28(4):242–5. https://doi.org/10.1097/IOP.0b013e31823f3266
Nerad JA. Diagnosis and management of the patient with tearing. In: Nerad JA, editor. Techniques in Ophthalmic Plastic Surgery. Cincinnati: Saunders Elsevier; 2010. p. 260–96.
Becelli R, Renzi G, Mannino G, Cerulli G, Lannetti G. Posttraumatic obstruction of lacrimal pathways: a retrospective analysis of 58 consecutive naso-orbitoethmoid fractures. J Craniofac Surg. 2004;15(1):29–33. https://doi.org/10.1097/00001665-200401000-00011
Finsterer J. Ptosis: causes, presentation, and management. Aesth Plast Surg. 2003;27(3):193–204. https://doi.org/10.1007/s00266-003-0127-5
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