Orbital Wall Reconstruction by Copying a Template(defect model) from the Facial CT in Blow-out Fracture

PURPOSE: Recently, orbital wall fracture is common injuries in the face. Facial CT is essential for the accurate diagnosis and appropriate treatment to reconstruct of the orbital wall. The objective of this study was to report the method for accurate measurement of area and shape of the bony defect in the blow-out fractures using facial CT in prior to surgery. METHODS: The authors experienced 46 cases of orbital wall fractures and examined for diplopia, sensory disturbance in the area of distribution of the infraorbital nerve, and enophthalmos in the preoperation and followed 1 months after surgery, from August 2007 to May 2008. Bony defect was predicted by measuring continuous defect size from 3mm interval facial CT. Copying from the defect model(template), we reconstructed orbital wall with resorbable sheet(Inion CPS(R), Inion Oy, Tampere, Finland). RESULTS: One months after surgery using this method, 26(100%) of the 26 patients improved in the diplopia and sensory disturbance in the area of distribution of the infraorbital nerve. Also 8(72.7%) of the 11 patients had enophthalmos took favorable turn. CONCLUSION: This accurate and time-saving method is practicable for determining the location, shape and size of the bony defect. Using this method, we can reconstruc

Orbital Wall Reconstruction by Copying a Template(defect model) from the Facial CT in Blow-out Fracture

PURPOSE: Recently, orbital wall fracture is common injuries in the face. Facial CT is essential for the accurate diagnosis and appropriate treatment to reconstruct of the orbital wall. The objective of this study was to report the method for accurate measurement of area and shape of the bony defect in the blow-out fractures using facial CT in prior to surgery. METHODS: The authors experienced 46 cases of orbital wall fractures and examined for diplopia, sensory disturbance in the area of distribution of the infraorbital nerve, and enophthalmos in the preoperation and followed 1 months after surgery, from August 2007 to May 2008. Bony defect was predicted by measuring continuous defect size from 3mm interval facial CT. Copying from the defect model(template), we reconstructed orbital wall with resorbable sheet(Inion CPS(R), Inion Oy, Tampere, Finland). RESULTS: One months after surgery using this method, 26(100%) of the 26 patients improved in the diplopia and sensory disturbance in the area of distribution of the infraorbital nerve. Also 8(72.7%) of the 11 patients had enophthalmos took favorable turn. CONCLUSION: This accurate and time-saving method is practicable for determining the location, shape and size of the bony defect. Using this method, we can reconstruc

Development and Application of Critical Pathway for Orbital Wall Fracture Patients

PURPOSE: The aim of this study is to develop and apply the critical pathway to the orbital wall fracture patients and to elucidate its effect. METHODS: Critical pathway(CP) sheet and questionnaire were developed by a team approach. Critical pathway was applied to 7 orbital wall fracture patients (CP group) from April 2006 to September 2006. Length of hospitalization and cost for hospitalization of CP group were compared to those of the 10 patients who had same disease entities and treated by conventional regimen(control group). RESULTS: Length of hospitalization in the CP group (7.20 day) were insignificantly shorter than that of control group(8.71 day). Mean cost for hospitalization of the CP group(776,398 won) were insignificantly lower than that of control group(1,028,531 won). The patients satisfaction for the explanation regarding operation procedure, therapeutic operation fee, length of hospitalization and medical personnel were all affirmative. CONCLUSION: Critical pathway that we developed for orbital wall fracture definitely improved the quality of treatment. Furthermore, other critical pathways should be developed for another facial trauma patients.