Morphometric Study to Assess Dimensions of Orbital Roof and Floor In Dry Skulls

Background: The orbit is a craniofacial structure that can beaffected by a large number of congenital, traumatic, neoplastic,vascular, and endocrine disorders. Therefore, the presentstudy was conducted to assess dimensions of orbital roof andfloor in dry skulls.Materials and Methods: The present study was conducted toassess dimensions of orbital roof and floor in 55 dry skullswhich were collected from the Department of Anatomy,Teerthanker Mahaveer Medical College & Research Centre,TMU, Moradabad, Uttar Pradesh, India. Based on themorphology, skulls were differentiated into 36 male and 19female skulls. The roof length and floor length of the orbit wasmeasured. The data obtained were tabulated and analyzedusing Statistical Package for the Social Sciences, Version 21.0(SPSS, Chicago, IL). The results were considered significantwhen p < 0.05.Results: In the present study total sample size was 55 dryskulls in which 36 were male skulls and 19 were female skulls.In male mean roof length was 5.43 and in female mean rooflength was 4.65. In male mean floor length was 4.81 and infemale mean floor length was 4.76. The right mean roof lengthwas 4.22 and left mean roof length was 4.93. In right meanfloor length was 4.45 and left mean floor length was 4.86.Conclusion: Present study concluded that mean roof lengthand floor length was greater in males. The left roof and floorlength were greater than right roof length.

Traumatic Globe Displacement Into Anterior Cranial Fossa

@#A 64-year-old Malay gentleman alleged occupational injury when a malfunctioned metal hydraulic door hit on his face while unloading sand from his tipper-truck. Post-trauma, he complained of right eye (RE) pain and total loss of vision. On examination, noted RE visual acuity was unable to be assessed and left eye (LE) was 6/24 with pinhole 6/9. No eyeball could be seen in the right socket with superior orbital rim step deformity and left periorbital haematoma. Computed tomography scan of the brain and orbit confirmed displaced right eye globe into the right anterior cranial fossa with right and left multiple orbital wall fractures. He then underwent successful right eye globe repositioning. Traumatic orbital roof fracture is a rare condition. Repositioning of the eye globe was done to salvage the eye globe for a cosmetic reason and to avoid localised inflammatory reaction at the anterior cranial fossa.

Morphometry Of Orbit In South Indian Dry Skulls - Dimensions Of Orbital Roof And Floor

Background: The human orbit is a complex anatomic region. Each of its four bony walls has its own uniquefeatures and is perforated by a number of fissures and foramina that carry important nerves and blood vessels.This is an anatomical region which is of clinical & surgical interest to many disciplines like ophthalmology, oraland maxillofocial surgery and neurosurgery. This morphometric study is undertaken to provide the normalreference values of roof and floor of the orbit in south Indian population.Materials and Methods: The study was done on 200 skulls (105 males and 95 females). The length of orbital roofand floor were measured by using manual vernier caliper. All the data obtained were tabulated and analysedstatistically by computing descriptive statistics like mean, standard deviation and range. Mann-Whitney testwas done to find out the statistical significance of all parameters of orbits, with respect to gender and side (rightand left side).Results: The results showed that the length of orbital roof and floor were significantly larger in males than infemales. There were no significant differences in between the right and left side orbits.Conclusion: This study has compared the orbital roof and floor length between the genders and between the sidesof the skulls. The prior knowledge of the orbital parameters may help to restore the normal anatomy of the orbitduring maxillofacial and reconstructive surgeries.

Skeletal cavernous hemangiomas of the frontal bone with orbital roof and rim involvement

Skeletal cavernous hemangiomas are rare, benign tumors that may involve the supraorbital rim and orbital roof. However, such involvement is extremely rare. We report a case of skeletal cavernous hemangioma of the frontal bone involving the orbital roof and rim. En bloc excision and reconstruction, using a calvarial bone graft for the orbital roof and rim defect, was performed. It is important not only to perform total excision of skeletal cavernous hemangiomas, but to properly reconstruct the defects after the total excision since several complications can arise from an orbital roof and rim defect.

Clinical Manifestations, Management, and Ophthalmologic Complications of Orbital Roof Fractures and Zygoma Fractures

PURPOSE: To investigate the clinical manifestations, management, and ophthalmologic complications of orbital roof fractures and zygoma fractures. METHODS: A retrospective survey of 119 patients who visited Korea University Medical Center from June 2009 to June 2010 was performed. The sex, age, causes, fracture characteristics, neurologic injury, ocular injury, and combined facial bone fractures of patients who were diagnosed with orbital roof fracture and zygoma fracture were statistically analyzed. RESULTS: The mean age of patients with orbital roof fracture was 33.0 years old. The most common cause of orbital roof fracture was traffic accident (36.1%) with 6 patients receiveing surgical treatement (9.8%). Among the ophthalmologic diagnoses of the patients with orbital roof fracture, traumatic iridocyclitis was the most common (7 eyes) followed by eyeball rupture (2 eyes). The mean age of patients with zygoma fracture was 36.6 years old. The most common cause of zygoma fracture was traffic accident (32.8%), with 51 patients receiving surgical treatement (87.9%). Among the ophthalmologic diagnoses of the patients with zygoma fracture, traumatic iridocyclitis was the most common (6 eyes), followed by commotio retina (4 eyes). CONCLUSIONS: The present study regarding clinical characteristics and treatment of orbital roof fracture and zygoma fracture is helpful for ophthalmologists regarding the treatment of accompanying ophthalmologic complications.

Periorbital Cerebrospinal Fluid Collection after Orbital Roof Craniotomy and Superolateral Orbital Craniotomy

OBJECTIVE: The aims of this study are to review the incidence of cerebrospinal fluid(CSF) collection complicating the simplified anterior skull base approaches via an eyebrow incision and to identify factors that influence its occurrence and treatment. METHODS: The authors retrospectively analyzed the clinical records and radiologic data of 47 cases(45 patients) who underwent superolateral orbital craniotomy or orbital roof craniotomy via an eyebrow incision at the Eulji Medical Center from September 1998 to August 2002. Forty-three cases were anterior circulation aneurysms and four cases were brain tumors. RESULTS: Significant periorbital CSF collection occurred in 13 cases(11 aneurysms, 2 brain tumors). It was managed with aspiration(8 cases), aspiration and lumbar drainage(2 cases), and dural repair(3 cases). There was no statistically significant difference in operative approaches and patient's characteristics. Periorbital CSF collection occurred in one(16.7%) of six cases using preventive lumbar CSF drainage over two days and in 12 (29.3%) out of 41 cases without it(p>005). CONCLUSION: The authors suggest that careful dissection and water-tight closure of frontal dura, sealing with fibrin glue and compressive dressing of operative wounds are important for the prevention of this complication. However, statistically not significant, preventive lumbar CSF drainage seem to be effective. Aspiration and/or lumbar drainage seem to be sufficient for management of postoperative CSF collection and dural repair could be reserved for refractory cases.

A Simplified Skull Base Approaches for Anterior Circulation Aneurysms: Superolateral Orbital Craniotomy and Orbital Roof Craniotomy viaan Eyebrow Incision

OBJECTIVE: Previous standard surgical approaches for aneurysms of anterior circulation are concerned with possible injury to the normal brain by cerebral retraction. Simplified skull base approaches have been introduced to fulfill the ideal goals of skull base surgery, brain protection and technical minimalism. Superolateral orbital craniotomy and orbital roof craniotomy via eyebrow incision offered sufficient working space for aneurysmal neck clipping of anterior circulaton and have advantages of minimal brain retraction and rapid recovery. METHODS: The concept and technique of the superolateral orbital craniotomy and orbital roof craniotomy are presented in detail. We conducted a retrospective study in which we evaluated the technical aspect of the superolateral orbital craniotomy and orbital roof craniotomy considering the indications, limitations, and complications of these approaches. RESULTS: The superolateral orbital craniotomy and orbital roof craniotomy provide an ample space to access the neurovascular structure of the anterior skull base without using brain retractors, enable rapid anatomical reconstruction for closure and acceptable cosmetic results. CONCLUSION: The superolateral orbital craniotomy and orbital roof craniotomy via eyebrow incision offer better surgical possibilities and approach related morbidity than conventional approaches in the treatment of anterior circulation aneurysms.

A Simplified Skull Base Approaches for Anterior Circulation Aneurysms: Superolateral Orbital Craniotomy and Orbital Roof Craniotomy viaan Eyebrow Incision

OBJECTIVE: Previous standard surgical approaches for aneurysms of anterior circulation are concerned with possible injury to the normal brain by cerebral retraction. Simplified skull base approaches have been introduced to fulfill the ideal goals of skull base surgery, brain protection and technical minimalism. Superolateral orbital craniotomy and orbital roof craniotomy via eyebrow incision offered sufficient working space for aneurysmal neck clipping of anterior circulaton and have advantages of minimal brain retraction and rapid recovery. METHODS: The concept and technique of the superolateral orbital craniotomy and orbital roof craniotomy are presented in detail. We conducted a retrospective study in which we evaluated the technical aspect of the superolateral orbital craniotomy and orbital roof craniotomy considering the indications, limitations, and complications of these approaches. RESULTS: The superolateral orbital craniotomy and orbital roof craniotomy provide an ample space to access the neurovascular structure of the anterior skull base without using brain retractors, enable rapid anatomical reconstruction for closure and acceptable cosmetic results. CONCLUSION: The superolateral orbital craniotomy and orbital roof craniotomy via eyebrow incision offer better surgical possibilities and approach related morbidity than conventional approaches in the treatment of anterior circulation aneurysms.

A Case of Exophthalmos due to Traumatic Orbital Encephalocele

Exophthalmos after trauma may develop because of retrobulbar hemorrhage, carotid cavernous fistula and orbital roof fracture. The orbital roof is composed of two layers of strong bone that makes it the strongest among the orbital walls and reports of its case are hardly found. However, rarely strong impact such as in automobile accidents causes these fractures and exophthalmos may develop due to herniation of brain tissue through a traumatic defect in the roof of the orbit. The authors experienced gradually increasing exophthalmos in a 33-year old man who had developed a subdural hematoma, orbital roof fracture and anterior temporal skull fracture due to an automobile accident. We report a case of orbital roof fracture in which herniation of brain was shown in orbital computed tomography and exophthalmos disappeared after dural suture.

Evaluation of Three-Dimentional Computerized Tomography Image of the Growing Skull Fracture on the Orbital Roof

Growing skull fracture is a rare complication of a closed head injury during infancy and childhood. Most growing skull fracture are located in the parietal region. The authors report a case of growing skull fracture of the orbital roof using three dimentional computerized tomography(3-D CT) imaging, the shpae and the size of defect were clearly demonstrated.