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

Magnetic Resonance sagittal scans of the fractured orbit (T2-dependet images). Lack of signal in the area of bone tissue. Part of the inferior rectus muscle has been displaced into the maxillary sinus. Arrow indicates the zone of tissue entrapment. (A) 30° upgaze, (B) Primary position, (C) 30° downgaze.
© Copyright Policy
Related In: Results  -  Collection


getmorefigures.php?uid=PMC3539610&req=5

f3-medscimonit-17-8-cs94: Magnetic Resonance sagittal scans of the fractured orbit (T2-dependet images). Lack of signal in the area of bone tissue. Part of the inferior rectus muscle has been displaced into the maxillary sinus. Arrow indicates the zone of tissue entrapment. (A) 30° upgaze, (B) Primary position, (C) 30° downgaze.

Mentions: In then particular patient the dMRI was focused on the action of the left inferior rectus muscle (1.5T MRI, Siemens Avanto). It exhibited a sudden increase in its cross-sectional area when measured in the coronal plane on slices representing the central part of the muscle body. Additionally, on the sagittal scans the site of restriction was clearly visible, especially during 30° upgaze (Figure 3). These findings were consistent with theoretical considerations suggesting that in certain cases of limited depression and elevation the former does not result from muscle paresis but from its restriction in its central section. In such patients the effective contractile force of the inferior rectus is reduced because only its anterior part is capable of rotating the globe [10].


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)

Magnetic Resonance sagittal scans of the fractured orbit (T2-dependet images). Lack of signal in the area of bone tissue. Part of the inferior rectus muscle has been displaced into the maxillary sinus. Arrow indicates the zone of tissue entrapment. (A) 30° upgaze, (B) Primary position, (C) 30° downgaze.
© Copyright Policy
Related In: Results  -  Collection

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

f3-medscimonit-17-8-cs94: Magnetic Resonance sagittal scans of the fractured orbit (T2-dependet images). Lack of signal in the area of bone tissue. Part of the inferior rectus muscle has been displaced into the maxillary sinus. Arrow indicates the zone of tissue entrapment. (A) 30° upgaze, (B) Primary position, (C) 30° downgaze.
Mentions: In then particular patient the dMRI was focused on the action of the left inferior rectus muscle (1.5T MRI, Siemens Avanto). It exhibited a sudden increase in its cross-sectional area when measured in the coronal plane on slices representing the central part of the muscle body. Additionally, on the sagittal scans the site of restriction was clearly visible, especially during 30° upgaze (Figure 3). These findings were consistent with theoretical considerations suggesting that in certain cases of limited depression and elevation the former does not result from muscle paresis but from its restriction in its central section. In such patients the effective contractile force of the inferior rectus is reduced because only its anterior part is capable of rotating the globe [10].

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