Limits...
The use of modern imaging techniques in the diagnosis and treatment planning of patients with orbital floor fractures.

Loba P, Kozakiewicz M, Elgalal M, Stefańczyk L, Broniarczyk-Loba A, Omulecki W - Med. Sci. Monit. (2011)

Bottom Line: Dynamic magnetic resonance imaging (dMRI) was performed, which revealed restriction of the left inferior rectus muscle in its central section.A patient-specific anatomical model was prepared on the basis of 3-dimensional computed tomography (CT) study of the intact orbit, which was used to prepare a custom pre-bent titanium mesh implant.Modern imaging techniques such as dMRI and 3-dimensional CT reconstruction allow us to better understand the pathophysiology of orbital floor fractures and to precisely plan surgical treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Medical University of Lodz, University Hospital No 1, Lodz, Poland. ploba@onet.pl

ABSTRACT

Background: Ocular motility impairment associated with orbital trauma may have several causes and manifest with various clinical symptoms. In some cases orbital reconstructive surgery can be very challenging and the results are often unsatisfactory. The use of modern imaging techniques aids proper diagnosis and surgical planning.

Case report: The authors present the case of a 29-year-old male who sustained trauma to the left orbit. Orthoptic examination revealed limited supra- and infraduction of the left eye. The patient reported diplopia in upgaze and downgaze with primary position spared. Dynamic magnetic resonance imaging (dMRI) was performed, which revealed restriction of the left inferior rectus muscle in its central section. A patient-specific anatomical model was prepared on the basis of 3-dimensional computed tomography (CT) study of the intact orbit, which was used to prepare a custom pre-bent titanium mesh implant. The patient underwent reconstructive surgery of the orbital floor.

Conclusions: Modern imaging techniques such as dMRI and 3-dimensional CT reconstruction allow us to better understand the pathophysiology of orbital floor fractures and to precisely plan surgical treatment.

Show MeSH

Related in: MedlinePlus

Hess chart plotted before reconstructive surgery. Hess chart plotted after reconstructive surgery.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3539610&req=5

f2-medscimonit-17-8-cs94: Hess chart plotted before reconstructive surgery. Hess chart plotted after reconstructive surgery.

Mentions: Orthoptic examination revealed limited supra- and infraduction of the left eye. The patient reported diplopia in upgaze and downgaze with primary position spared. Prismatic cover-test for distance was 0Δ with 0.5Δ right-sided hypertropia (RHT) in primary position, but in upgaze it was 4Δ with 16Δ RHT and in downgaze 2Δ with 10Δ left-sided hypertropia (LHT). Detailed examination on a major amblyoscope in 9 gaze positions showed that vertical deviation increased when the affected (left) eye was abducted. Subsequently, a Hess chart was plotted (Figure 2A). The clinical picture presented by the patient led to the conclusion that the cause of ocular motility limitation was a combination of paresis (limited depression) and restriction (limited elevation) of the left inferior rectus muscle. Due to the fact that this diagnosis was uncertain, the patient was referred for a dMRI of the extraocular muscles.


The use of modern imaging techniques in the diagnosis and treatment planning of patients with orbital floor fractures.

Loba P, Kozakiewicz M, Elgalal M, Stefańczyk L, Broniarczyk-Loba A, Omulecki W - Med. Sci. Monit. (2011)

Hess chart plotted before reconstructive surgery. Hess chart plotted after reconstructive surgery.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3539610&req=5

f2-medscimonit-17-8-cs94: Hess chart plotted before reconstructive surgery. Hess chart plotted after reconstructive surgery.
Mentions: Orthoptic examination revealed limited supra- and infraduction of the left eye. The patient reported diplopia in upgaze and downgaze with primary position spared. Prismatic cover-test for distance was 0Δ with 0.5Δ right-sided hypertropia (RHT) in primary position, but in upgaze it was 4Δ with 16Δ RHT and in downgaze 2Δ with 10Δ left-sided hypertropia (LHT). Detailed examination on a major amblyoscope in 9 gaze positions showed that vertical deviation increased when the affected (left) eye was abducted. Subsequently, a Hess chart was plotted (Figure 2A). The clinical picture presented by the patient led to the conclusion that the cause of ocular motility limitation was a combination of paresis (limited depression) and restriction (limited elevation) of the left inferior rectus muscle. Due to the fact that this diagnosis was uncertain, the patient was referred for a dMRI of the extraocular muscles.

Bottom Line: Dynamic magnetic resonance imaging (dMRI) was performed, which revealed restriction of the left inferior rectus muscle in its central section.A patient-specific anatomical model was prepared on the basis of 3-dimensional computed tomography (CT) study of the intact orbit, which was used to prepare a custom pre-bent titanium mesh implant.Modern imaging techniques such as dMRI and 3-dimensional CT reconstruction allow us to better understand the pathophysiology of orbital floor fractures and to precisely plan surgical treatment.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Medical University of Lodz, University Hospital No 1, Lodz, Poland. ploba@onet.pl

ABSTRACT

Background: Ocular motility impairment associated with orbital trauma may have several causes and manifest with various clinical symptoms. In some cases orbital reconstructive surgery can be very challenging and the results are often unsatisfactory. The use of modern imaging techniques aids proper diagnosis and surgical planning.

Case report: The authors present the case of a 29-year-old male who sustained trauma to the left orbit. Orthoptic examination revealed limited supra- and infraduction of the left eye. The patient reported diplopia in upgaze and downgaze with primary position spared. Dynamic magnetic resonance imaging (dMRI) was performed, which revealed restriction of the left inferior rectus muscle in its central section. A patient-specific anatomical model was prepared on the basis of 3-dimensional computed tomography (CT) study of the intact orbit, which was used to prepare a custom pre-bent titanium mesh implant. The patient underwent reconstructive surgery of the orbital floor.

Conclusions: Modern imaging techniques such as dMRI and 3-dimensional CT reconstruction allow us to better understand the pathophysiology of orbital floor fractures and to precisely plan surgical treatment.

Show MeSH
Related in: MedlinePlus