Abducens Nerve Palsy Complicated by Inferior Petrosal Sinus Septic Thrombosis Due to Mastoiditis

We present a very rare case of a 29-month-old boy with acute onset right abducens nerve palsy complicated by inferior petrosal sinus septic thrombosis due to mastoiditis without petrous apicitis. Four months after mastoidectomy, the patient fully recovered from an esotropia of 30 prism diopters and an abduction limitation (-4) in his right eye.

A Case of Ptosis Blowout Fracture of the Inferior Orbital Wall / 대한이비인후과학회지

Blow out fractures occur in many patients who suffer from blunt trauma in the face. The typical signs and symptoms are diplopia, limited eye movement and enophthalmos. Upper eyelid ptosis is a relatively rare symptom caused by blowout fracture, where traumatic ptosis accounts for only 1-9%. The etiology is usually the result of a direct levator muscle injury due to eyelid trauma. Sometimes traumatic blepharoptosis occurs due to ischemic damage to the superior branch of the oculomotor nerve. Generally, blepharoptosis caused by blow out fracture is treated with conservative treatment unless there is some evidence of bone impingement. The authors report one case of blepharoptosis caused by blow out fracture, which was treated successfully.

A Case of Foreign Body Incidentally Found at the Maxilla and Maxillary Sinus / 대한이비인후과학회지

Foreign bodies in the maxillary sinus are rare and mostly of traumatic origin. These foreign bodies result in pain, bleeding and infection and are immediately removed in most cases. Sometimes the foreign body without serious symptoms can remain for several years without treatment. However, the prognosis of foreign bodies in the paranasal sinuses can be severe. Therefore, regardless of the symptoms present, it seems worthwhile to remove the foreign body from the paranasal sinuses in order to prevent any possibility of further complications. The authors report a case of foreign body occurring in maxilla and maxillary sinus without symptoms for 25 years with related literatures.

Delayed Onset Diplopia due to Minimal Orbital Floor Fractures 16 Months Previously / 대한이비인후과학회지

Ocular symptoms related to orbital fracture occur immediately after the fracture in most cases. However, authors experienced a delayed onset diplopia occurred 16 months after orbital floor fracture. A 19-year-old man, who had right orbital floor fracture 16 months ago, presented with diplopia of upward gaze. At the time of the fracture, no surgery was performed because the fracture was minimal and there were no particular symptoms. Physical examinations revealed a minor ocular motility restriction of upward gaze, but orbital floor showed no definite interval change on computed tomography. Severe adhesion between the orbital fat tissue and orbital floor was noted intraoperatively and the adhesion was dissected. After the operation, the patient showed remarkable improvement in diplopia and restriction of the ocular motility.

Update in Treatment of Orbital Blowout Fractures / 대한이비인후과학회지

The orbital wall is commonly fractured and its incidence ranges from 18 to 50% of all craniofacial fractures.1,2) Numerous papers have been reported about the surgical indication, surgical timing, approach options, and reconstruction materials for orbital blowout fractures. However, there are still debates on the ideal surgical options. The choice of surgical approach and materials for reduction of orbital blowout fractures depends on the surgeon's experience and preference. Recently, use of endoscope for blowout fractures has been popular worldwide due to its advantages over open reduction surgeries. In this review, I will discuss new techniques and concepts of the treatment of orbital blowout fractures with particular references.

2 Cases of Optic Nerve Decompression of Two Traumatic Optic Neuropathies Using Intranasal Endoscope / 대한이비인후과학회지

Traumatic optic neuropathy is a complication resulting from facial trauma, with an incidence of 2% to 5%. The most widely accepted treatments include observation, high dose steroid, surgical decompression and combination therapy of steroid and surgical treatment. However, there has been no established mode of treatment and there are still debates about what the best treatment should be for the patients with optic canal fracture. We experienced two cases of traumatic optic neuropathies due to intracanalicular fracture of the optic canal after trauma. Surgical decompression was performed using an endoscope int-ranasally one day after injury as required for minimal invasive surgery. We report the results and progression of these two cases.

Reconstruction of Bony Orbit Using Endoscope and Polyethylene with Embedded Titanium for a Patient with Postoperative Enophthalmos / 대한이비인후과학회지

Enophthalmos means displacement of the globe into the bony orbit backward, and usually downward. In post-traumatic enophthalmos, the mechanisms that determine the globe position can be the enlargement of the orbital cavity, the herniation of orbital fat into the maxillary sinus, fat atrophy, loss of ligament support, and scar contracture. It can be reconstructed through several approaches such as transconjunctival, canthotomy, lower eye lid, coronal approach, and by using bone, cartilage, and alloplastic materials. The authors report a case of postoperative enophthalmos reconstructed through subciliary and transnasal endoscopic approaches using porous polyethylene with embedded titanium.