Bony landmarks of the medial orbital wall: An anatomical study of ethmoidal foramina

2013 ◽  
Vol 27 (4) ◽  
pp. 570-577 ◽  
Author(s):  
Maria Piagkou ◽  
Georgia Skotsimara ◽  
Aspasia Dalaka ◽  
Eftychia Kanioura ◽  
Vasiliki Korentzelou ◽  
...  
Keyword(s):  
Anatomical Study ◽  
Bony Landmarks ◽  
Orbital Wall ◽  
Medial Orbital Wall

Resources: Internet Resources for the Independent Medical Evaluator – 2007

2007 ◽  
Vol 12 (4) ◽  
pp. 4-7
Author(s):  
Christopher R. Brigham ◽  
Jenny Walker
Keyword(s):  
Head Trauma ◽  
Clonic Seizure ◽  
Acute Subdural Hematoma ◽  
Orbital Fracture ◽  
Orbital Wall ◽  
First Occurrence ◽  
One Year ◽  
The One ◽  
Neurological Injuries ◽  
Medial Orbital Wall

Abstract Rating patients with head trauma and multiple neurological injuries can be challenging. The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, Section 13.2, Criteria for Rating Impairment Due to Central Nervous System Disorders, outlines the process to rate impairment due to head trauma. This article summarizes the case of a 57-year-old male security guard who presents with headache, decreased sensation on the left cheek, loss of sense of smell, and problems with memory, among other symptoms. One year ago the patient was assaulted while on the job: his Glasgow Coma Score was 14; he had left periorbital ecchymosis and a 2.5 cm laceration over the left eyelid; a small right temporoparietal acute subdural hematoma; left inferior and medial orbital wall fractures; and, four hours after admission to the hospital, he experienced a generalized tonic-clonic seizure. This patient's impairment must include the following components: single seizure, orbital fracture, infraorbital neuropathy, anosmia, headache, and memory complaints. The article shows how the ratable impairments are combined using the Combining Impairment Ratings section. Because this patient has not experienced any seizures since the first occurrence, according to the AMA Guides he is not experiencing the “episodic neurological impairments” required for disability. Complex cases such as the one presented here highlight the need to use the criteria and estimates that are located in several sections of the AMA Guides.

scholarly journals Ethnic variation in medial orbital wall anatomy and its implications for decompression surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Minhui Amy Chan ◽  
Farah Ibrahim ◽  
Arjunan Kumaran ◽  
Kailing Yong ◽  
Anita Sook Yee Chan ◽  
...  
Keyword(s):  
Relative Position ◽  
Ethmoid Sinus ◽  
Decompression Surgery ◽  
Ethnic Variation ◽  
Sinus Wall ◽  
Orbital Wall ◽  
Mean Width ◽  
Significant Difference ◽  
The Mean ◽  
Medial Orbital Wall

Abstract Background To describe the inter-ethnic variation in medial orbital wall anatomy between Chinese, Malay, Indian and Caucasian subjects. Methods Single-centre, retrospective, Computed Tomography (CT)-based observational study. 20 subjects of each ethnicity, were matched for gender and laterality. We excluded subjects younger than 16 years and those with orbital pathology. OsiriX version 8.5.1 (Pixmeo., Switzerland) and DICOM image viewing software CARESTREAM Vue PACS (Carestream Health Inc., USA) were used to measure the ethmoidal sinus length, width and volume, medial orbital wall and floor angle and the relative position of the posterior ethmoid sinus to the posterior maxillary wall. Statistical analyses were performed using Statistical Package for Social Sciences version 25.0 (IBM, USA). Results There were 12 males (60 %) in each group, with no significant difference in age (p = 0.334–0.994). The mean ethmoid sinus length in Chinese, Malay, Indian and Caucasian subjects, using the Chinese as reference, were 37.2, 36.9, 38.0 and 37.4mm, the mean width was 11.6, 10.5, 11.4 and 10.0mm (p = 0.020) and the mean ethmoid sinus volume were 3362, 3652, 3349 and 3898mm3 respectively. The mean medial orbital wall and floor angle was 135.0, 131.4, 131.0 and 136.8 degrees and the mean relative position of posterior ethmoid sinus to posterior maxillary wall were − 2.0, -0.2, -1.5 and 1.6mm (p = 0.003) respectively. Conclusions No inter-ethnic variation was found in decompressible ethmoid sinus volume. Caucasians had their posterior maxillary sinus wall anterior to their posterior ethmoidal walls unlike the Chinese, Malay and Indians. Awareness of ethnic variation is essential for safe orbital decompression.

scholarly journals Six cases of fracture of the medial orbital wall.

1986 ◽  
Vol 79 (12) ◽  
pp. 2049-2053
Author(s):  
Hiroshi FUJITA ◽  
Yasushi MATSUMOTO ◽  
Masafumi TANI ◽  
Kako NAKANO ◽  
Masanori SADAMOTO ◽  
...  
Keyword(s):  
Orbital Wall ◽  
Medial Orbital Wall

Medial orbital wall fracture with concomitant medial longitudinal fasciculus lesions

2003 ◽  
Vol 26 (2) ◽  
pp. 96-98
Author(s):  
H. Fındık ◽  
N. Karacaoğlan ◽  
A. Duman ◽  
A. Mısıroğlu
Keyword(s):  
Medial Longitudinal Fasciculus ◽  
Orbital Wall ◽  
Medial Orbital Wall

Inlay Implanting Technique for the Correction of Medial Orbital Wall Fracture

2011 ◽  
Vol 127 (1) ◽  
pp. 321-326 ◽  
Author(s):  
Yong-Ha Kim ◽  
Tae Gon Kim ◽  
Jun Ho Lee ◽  
Hyun Jae Nam ◽  
Jong Hyo Lim
Keyword(s):  
Orbital Wall ◽  
Medial Orbital Wall

The Usability of the Upper Eyelid Crease Approach for Correction of Medial Orbital Wall Blowout Fracture

2012 ◽  
Vol 130 (4) ◽  
pp. 898-905 ◽  
Author(s):  
Hak Su Kim ◽  
Seong Eon Kim ◽  
Gregory R. D. Evans ◽  
Sun Hee Park
Keyword(s):  
Upper Eyelid ◽  
Blowout Fracture ◽  
Orbital Wall ◽  
Medial Orbital Wall

Intranasal Sphenoethmoidectomy: An Evolution of Technique

1994 ◽  
Vol 111 (6) ◽  
pp. 781-786 ◽  
Author(s):  
George P. Katsantonis ◽  
William H. Friedman ◽  
Matthew Bruns
Keyword(s):  
Middle Turbinate ◽  
Sinus Disease ◽  
Pterygoid Process ◽  
Primary Indication ◽  
Orbital Wall ◽  
Middle Meatal Antrostomy ◽  
Medial Orbital Wall ◽  
Palatine Bone ◽  
Maxillary Sinuses

Intranasal sphenoethmoldectomy was originally used primarily for the provision of adequate drainage of acute and subacute bacterial sinusitis. However, the spectrum of inflammatory sinus disease has changed dramatically since the popularization of broad-spectrum antibiotics, and chronic hyperplastic rhinosinusitis has replaced acute sinusitis as the primary indication for ethmoidectomy. In such cases total or almost total disease removal is crucial to providing long-term drainage and ventilation. We describe several modifications of the Yankauer sphenoethmoldectomy technique that enable the sinus surgeon to provide clearance of disease and excellent drainage for all sinuses by complete marsupialization of the sphenoid, ethmoid, and maxillary sinuses. These modifications include (1) complete rather than partial removal of the middle turbinate. (2) extended middle meatal antrostomy with palatine bone resection to the pterygoid process with delineation of the inferior and medial orbital wall, and (3) Introduction of operative endoscopes as adjunctive tools in areas inaccessible to conventional visualization. The current technique and results in nearly 2000 procedures are described.

Management of Orbital Cellulitis

2011 ◽  
Author(s):  
Thomas E. Johnson ◽  
Jennifer I. Hui
Keyword(s):  
Allergic Inflammation ◽  
Mucosal Blood Flow ◽  
Orbital Cellulitis ◽  
Common Source ◽  
Orbital Wall ◽  
Upper Respiratory ◽  
Medial Orbital Wall ◽  
Ethmoid Sinuses ◽  
Insect Bites ◽  
Sinus Mucosa

Orbital cellulitis is an acute infectious inflammation of the post-septal orbital tissues. This chapter outlines the medical and surgical management of bacterial orbital cellulitis. The paranasal sinus complex is the most common source of orbital bacterial infection. Over 50% of orbital cellulitis cases result from secondary extension from the paranasal sinuses. Other causes of orbital cellulitis include spread from ocular and periocular infections such as dacryoadenitis, dacryocystitis, and panophthalmitis; trauma, insect bites, or surgery; or endogenous sources in immunocompromised or septic patients. Orbital cellulitis resulting from sinusitis is believed to start with viral or allergic inflammation of the upper respiratory system. The inflammation decreases mucociliary clearance and causes obstruction of the sinus ostia. The sinus mucosa absorbs air, thereby creating negative pressure within the sinuses. Transudation occurs, creating a nutrient medium for bacteria. Aerobic and facultative organisms proliferate, and inflammatory products accumulate resulting in decreasing oxygen tension and pH. As inflammatory products are produced, sinus pressure increases, causing mucosal blood flow to decrease. A proliferation of obligate anaerobes occurs as aerobic bacteria consume the remaining oxygen. Young children are less likely to develop anaerobic conditions within their sinuses because their ratio of ostia size to sinus volume is much larger than that of adults. The sinus cavities enlarge markedly with age while the ostia remain approximately the same size. Thus, as children become adults, the decreased ratio of ostia size to total sinus volume increases the propensity for anaerobic sinus infections. The bony walls shared by the orbit and sinuses account for approximately half of the orbital surface area. Bacteria and inflammatory products from the sinuses may extend directly into the orbit through the neurovascular foramina, congenital bony dehiscences, anastomosing valveless venous channels, or compromised bony walls in cases of osteitis and necrosis secondary to sinusitis. An abscess may form in the subperiosteal area, a relatively avascular potential space. Subperiosteal abscesses most often involve the medial orbital wall, as it is the thinnest wall and is adjacent to the ethmoid sinuses.

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