Clinicoradiological evaluation of rare orbital injuries

AIM OF THE WORK: We aimed at recording rare cases with different orbital injuries and studying the difficulties in their diagnosis and management. PATIENT AND METHODS: A retrospective review of six cases of rare orbital injuries. All cases shared in visual impairment and some cases had either proptosis or enophthalmos. All cases underwent full history taking including type and mechanism of trauma, complete ophthalmic examination and computerized tomography [CT] examination. Clinical diagnosis was not conclusive. Accurate diagnosis was only achieved by CT. Management was different depending on each condition. One case had pure medial wall blow out fracture with the displaced globe traversing ethmoidal cells into nasal cavity, another one had bilateral medial wall blow in fracture with nasal fracture, two cases had intra orbital FBs; one of them had very large neglected woody FB and the other had gun shot passed through optic canal into middle cranial fossa, one had neglected orbital hematoma which changed into hematic cyst, and the last case had iatrogenic medial wall injury. CONCLUSION We concluded that in rare orbital injuries, we should not rely on clinical assessment only and CT is very essential diagnostic tool for such cases also there is no fixed role for surgery but it moulds itself according to each condition

Complications after surgery for oral and oropharyngeal malignancy

This study included 31 patients with oropharyngeal malignancy. Group I included 15 patients, 13 had stage II squamous cell carcinoma of the anterior 2-thirds of the tongue and 2 patients had squamous cell carcinoma of the floor of the mouth stage II. An adequate excision of the primary, repair of the residual part of the tongue, plus suprahyoid neck dissection were done for every patient in this group. Group II included 16 patients, in whom 7 had stage III squamous cell carcinoma of the anterior two thirds of the tongue, 5 patients had stage II squamous cell carcinoma of the retromolar trigone and 4 patients had stage II squamous cell carcinoma of the tonsillar region. Commando's operation was done with reconstruction by PMC flaps for every patient of this group. The patients were followed up meticulously in the postoperative period. Most of the complications were seen in group II after the Commando's operation, whether anatomical complication [nerves injury], functional [mastication, speech problems or dysphagia], esthetic [asymmetry of the face] and recurrence of the neoplasm after stage III. From this study, it was concluded that early presentation of patients, accurate, preoperative assessment and correction of any medical problem are important. The team therapy approach is an essential corner stone to minimize the postoperative complications as well as to help the patients and their family to expect better result from the treatment program and mode of rehabilitation. In addition, the proper choice of treatment planning and good surgical technique and the postoperative team [health care personnel] cooperation are mandatory for rehabilitation