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Otolaryngology, ENT & Sinus News Provided by Dallas ENTUpdate on orbital reconstructionAugust 1, 2010, 12:00 pm by Current Opinion in Otolaryngology & Head and Neck SurgeryPurpose of review: Orbital trauma is common and frequently complicated by ocular injuries. The recent literature on orbital fracture is analyzed with emphasis on epidemiological data assessment, surgical timing, method of approach and reconstruction materials. Recent findings: Computed tomographic (CT) scan has become a routine evaluation tool for orbital trauma, and mobile CT can be applied intraoperatively if necessary. Concomitant serious ocular injury should be carefully evaluated preoperatively. Patients presenting with nonresolving oculocardiac reflex, 'white-eyed' blowout fracture, or diplopia with a positive forced duction test and CT evidence of orbital tissue entrapment require early surgical repair. Otherwise, enophthalmos can be corrected by late surgery with a similar outcome to early surgery. The use of an endoscope-assisted approach for orbital reconstruction continues to grow, offering an alternative method. Advances in alloplastic materials have improved surgical outcome and shortened operating time. Summary: In this review of modern orbital reconstruction, several controversial issues such as surgical indication, surgical timing, method of approach and choice of reconstruction material are discussed. Preoperative fine-cut CT image and thorough ophthalmologic examination are key elements to determine surgical indications. The choice of surgical approach and reconstruction materials much depends on the surgeon's experience and the reconstruction area. Prefabricated alloplastic implants together with image software and stereolithographic models are significant advances that help to more accurately reconstruct the traumatized orbit. The recent evolution of orbit reconstruction improves functional and aesthetic results and minimizes surgical complications. (C) 2010 Lippincott Williams & Wilkins, Inc.
More from Current Opinion in Otolaryngology & Head and Neck Surgery Surgical management of common peripheral vestibular diseases Current Opinion in Otolaryngology & Head and Neck Surgery: August 20, 2010, 6:00 am Purpose of review: To review the latest developments in the surgical management of common peripheral vestibular disorders. Recent findings: Although surgery is indicated mainly for patients with Meniere's disease, other less common disorders Cochlear efferent innervation and function Current Opinion in Otolaryngology & Head and Neck Surgery: August 20, 2010, 6:00 am Purpose of review: This review covers topics relevant to olivocochlear-efferent anatomy and function for which there are new findings in papers from 2009 to early 2010. Recent findings: Work within the review period Reconstruction of cheek defects: a review of current techniques Current Opinion in Otolaryngology & Head and Neck Surgery: August 1, 2010, 12:00 pm Purpose of review: The article discusses the fundamental principles of cheek reconstruction and summarizes recently published techniques and reviews in the field. Recent findings: Reconstruction of the cheek is a complex endeavour. Patient, Editorial introductions Current Opinion in Otolaryngology & Head and Neck Surgery: August 1, 2010, 12:00 pm No abstract available Editorial introduction to the maxillofacial surgery section Current Opinion in Otolaryngology & Head and Neck Surgery: August 1, 2010, 12:00 pm No abstract available
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