View
222
Download
0
Category
Preview:
Citation preview
8/13/2019 Treatment Planning & Seminar Updated2
1/12
Treatment Planning & Seminar
Karam Bassam 200910300
Amrou Mohamed 200910538
8/13/2019 Treatment Planning & Seminar Updated2
2/12
The Case
Gender : Male Age : 32
PMH: Healthy
Patient is presented with BLOW to cheek
C/F: 1.Bruises
2.Blurred Vision
3. Diplopia
8/13/2019 Treatment Planning & Seminar Updated2
3/12
Differential Diagnosis
Possible causes of diplopia due to trauma
include:
Zygomatic Complex Fracture
Blowout Injury/Orbital Floor Fracture
1. Orbital contusion with associated edema,
hemorrhage, and muscle contusion2. Orbital fracture with/without entrapment
8/13/2019 Treatment Planning & Seminar Updated2
4/12
Zygomatic Complex fracture
Associated
Ocular Complications :
1-Retinal detachment.2-Dislocation of the lens.
3-Injuries to the globe.
4-Orbital floor fractures.
8/13/2019 Treatment Planning & Seminar Updated2
5/12
Orbital floor Fracture
8/13/2019 Treatment Planning & Seminar Updated2
6/12
Overview:
Strong TRAUMA
PAIN and BLOWOUTof orbital floor
1- BRUSIS.
2- DIPLOPIA.
3- EDEMA of EYELID.4- ENOPHTHALMOUS.
5- EPISTAXIS.
6- NAUSEA.
8/13/2019 Treatment Planning & Seminar Updated2
7/12
Clinical examination
Ocular examination for vision acuity.
Palpation of the orbit for creptius.
External examinationfor edema.
8/13/2019 Treatment Planning & Seminar Updated2
8/12
Investigations
Radiographs to confirm the diagnosis :
1. MRIfor examining the optic nerve
2. CT scan for the facial bones3. Occipitomental view
4. Submentovertex view for the zygomatic arch
8/13/2019 Treatment Planning & Seminar Updated2
9/12
Final Diagnosis
Zygomatic complex fracture
Reasons:
1. Blow to the cheek2. Ophthalmic nerve
3. Infraorbital nerve and artery
8/13/2019 Treatment Planning & Seminar Updated2
10/12
Treatment Plan
Aims
1-To correct diplopia and restore normal vision
2-To restore orbital volume when walls and floorare fractured
3-To restore the normal contour of the face for
cosmetic reasons.
8/13/2019 Treatment Planning & Seminar Updated2
11/12
Treatment of diplopia
Includes observation and surgical repair
Timing of surgery: As soon as initial edema or
hematoma subsides (5-7 days)
Considerations: presence or absence of
entrapment, prescence of
diplopia,enophtalmous
Transconjuctival approach preferred.
8/13/2019 Treatment Planning & Seminar Updated2
12/12
Treatment of possible zygomatic
fracture
Treatment objective: To place fragments in
normal position and to fix them during the
course of healing
Same period of time before the start of
surgery
Open reduction and intraosseous wire fixation
indicated.
Recommended