- Email: [email protected]
Oculomotor nerve palsy treated by superior orbitotomy approach
179 suture technique for end-to-side anastomosis is a highly reliable and time saving method. It keeps the donor vessel intact, and does not interrupt distal blood flow. The technique overcomes the problems of vessel size discrepancy and is the preferred procedure in microvascular free-tissue transfers in head and neck reconstruction at our department.
superior orbitotomy that is both conservative, rarely used and highly beneficial. http://dx.doi.org/10.1016/j.ijom.2017.02.613 Lateral orbitotomy with osteotomy: team approach to extraocular space occupying lesions
http://dx.doi.org/10.1016/j.ijom.2017.02.611 Platysma myocutaneous flap for intraoral reconstruction
I. Elimairi ∗ , A. Suleiman, A. Sami, A. Elnyal, B. Musa, A. Awad
A.M. Eckardt
National Ribat University and University of Khartoum, Sudan
Department of Cranio-Maxillofacial Surgery, Klinikum Bremerhaven, Germany
Background: Access to the orbital contents without osteotomy can proceed from the anterior orbit using either transcutaneous or transconjunctival approaches. As part of craniomaxillofacial surgery, surgical approaches to the ocular cavity have undergone significant changes. Perhaps the most important development is the formation of multidisciplinary teams involving maxillofacial surgeons, neurosurgeons, and eye surgeons. Objectives: The aim of this review is to comprehensively explore the role of oral and maxillofacial surgeon and the multidisciplinary approaches for the management of extraocular orbital lesions using lateral orbitotomy technique. Methods: 107 cases of orbital tumours/lesions were retrieved from the files of the oral and maxillofacial department at National Ribat University Hospital (August 1996 to May 2016). All patients’ files were reviewed to determine the association among pathological variables, age, details of procedure, outcomes and complications. The comparison of lateral orbitotomy with/without osteotomy in the removal of extraocular tumours and the advancement of team approach within this field in reducing postoperative complications is discussed. Results: In aggressive or extensive lesions surgery with osteotomy is the treatment of choice in order to completely excise the mass and to avoid or minimise chance of recurrence and morbidity. Conclusions: A multispecialty team facilitates diagnosis, staging, and extirpation of the tumour, thereby improving outcomes and providing acceptable cosmesis and functional reconstruction. Approaches and modifications of existing techniques have evolved to minimise injury of important neurovascular structures within and adjacent to the orbit.
Reconstruction of oral soft-tissue defects following resection of oral carcinomas can be achieved using various techniques including microsurgical tissue transfer. However, there seems to be a role for regional or local flaps. Small to medium-size defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The present paper reviews the indication, surgical technique, and complications following reconstruction of defects of the oral cavity with the platysma myocutaneous flap. http://dx.doi.org/10.1016/j.ijom.2017.02.612 Oculomotor nerve palsy treated by superior orbitotomy approach I. Elimairi ∗ , A.M. Elneil, B. Khair, E.Y.H. Babker, A.A. Hassan, A. Sami National Ribat University And Hospital, Sudan Background: Oculomotor nerve palsy caused by an extraaxial tumour is rare in the literature. There are marked features of the palsy presenting with complete opthalmoplegia, mydriasis and severe unilateral ptosis of the eye. An innovative surgical approach was used; that is superior orbitotomy with osteotomy (extracranial approach) which is underreported. Methods: We present a 14-year-old girl with complete ophthalmoplegia, mydriasis and profound ptosis of the right eye, of five months duration. Magnetic resonance imaging revealed extraaxial tumourous mass in the retrorbita. A superior orbital approach was chosen as this offered direct access to enucleate the lesion that was unsheathing the nerve. The approach avoids major neurovascular structures, although the supratrochlear and supraorbital neurovascular bundles were visualised and preserved. The approach provides an intermediate location between extra and transcranial approaches, however does increase the chances of an unaesthetic scar. Pupil sparing oculomotor palsy is often due to infarction of the nerve and is associated with diabetes. Smaller pupils may be associated with Horner’s syndrome or diabetic neuropathy. Results: Postoperatively, the patient’s opthalmoplegia was markedly resolved and ptosis improved dramatically. Conclusions: We discuss a case of optic nerve sheath meningioma with associated oculomotor palsy subsequently treated by superior orbitotomy with osteotomy. We highlight oculomotor palsy as a rare presenting feature and the innovative treatment of
http://dx.doi.org/10.1016/j.ijom.2017.02.614 Smoking and radiation history are significantly associated with osteosynthesis-associated delayed complications in free fibula reconstruction of mandible — a retrospective study S. Gokavarapu ∗ , Y.M. Chen, T. Ji, C.P. Zhang Department of Oral and Maxillofacial – Head and Neck Oncology, Shanghai Stomatology Key Laboratory, Ninth People’s Hospital School of Medicine, Shanghai Jiao Tong University School of Medicine, China Background: The osseous reconstruction after resection is the ideal choice for functional rehabilitation of mandible. Although the success rate of vascular fee fibula is high, late complications such as plate exposures and infections related to osteosynthesis are not uncommon. The choice of the type of dental rehabilitation is greatly influenced by such complications and defining risk factors are needed.
superior orbitotomy that is both conservative, rarely used and highly beneficial. http://dx.doi.org/10.1016/j.ijom.2017.02.613 Lateral orbitotomy with osteotomy: team approach to extraocular space occupying lesions
http://dx.doi.org/10.1016/j.ijom.2017.02.611 Platysma myocutaneous flap for intraoral reconstruction
I. Elimairi ∗ , A. Suleiman, A. Sami, A. Elnyal, B. Musa, A. Awad
A.M. Eckardt
National Ribat University and University of Khartoum, Sudan
Department of Cranio-Maxillofacial Surgery, Klinikum Bremerhaven, Germany
Background: Access to the orbital contents without osteotomy can proceed from the anterior orbit using either transcutaneous or transconjunctival approaches. As part of craniomaxillofacial surgery, surgical approaches to the ocular cavity have undergone significant changes. Perhaps the most important development is the formation of multidisciplinary teams involving maxillofacial surgeons, neurosurgeons, and eye surgeons. Objectives: The aim of this review is to comprehensively explore the role of oral and maxillofacial surgeon and the multidisciplinary approaches for the management of extraocular orbital lesions using lateral orbitotomy technique. Methods: 107 cases of orbital tumours/lesions were retrieved from the files of the oral and maxillofacial department at National Ribat University Hospital (August 1996 to May 2016). All patients’ files were reviewed to determine the association among pathological variables, age, details of procedure, outcomes and complications. The comparison of lateral orbitotomy with/without osteotomy in the removal of extraocular tumours and the advancement of team approach within this field in reducing postoperative complications is discussed. Results: In aggressive or extensive lesions surgery with osteotomy is the treatment of choice in order to completely excise the mass and to avoid or minimise chance of recurrence and morbidity. Conclusions: A multispecialty team facilitates diagnosis, staging, and extirpation of the tumour, thereby improving outcomes and providing acceptable cosmesis and functional reconstruction. Approaches and modifications of existing techniques have evolved to minimise injury of important neurovascular structures within and adjacent to the orbit.
Reconstruction of oral soft-tissue defects following resection of oral carcinomas can be achieved using various techniques including microsurgical tissue transfer. However, there seems to be a role for regional or local flaps. Small to medium-size defects can be functionally reconstructed with the platysma myocutaneous flap as an excellent choice particularly in medically compromised patients not being eligible for free tissue transfer. The present paper reviews the indication, surgical technique, and complications following reconstruction of defects of the oral cavity with the platysma myocutaneous flap. http://dx.doi.org/10.1016/j.ijom.2017.02.612 Oculomotor nerve palsy treated by superior orbitotomy approach I. Elimairi ∗ , A.M. Elneil, B. Khair, E.Y.H. Babker, A.A. Hassan, A. Sami National Ribat University And Hospital, Sudan Background: Oculomotor nerve palsy caused by an extraaxial tumour is rare in the literature. There are marked features of the palsy presenting with complete opthalmoplegia, mydriasis and severe unilateral ptosis of the eye. An innovative surgical approach was used; that is superior orbitotomy with osteotomy (extracranial approach) which is underreported. Methods: We present a 14-year-old girl with complete ophthalmoplegia, mydriasis and profound ptosis of the right eye, of five months duration. Magnetic resonance imaging revealed extraaxial tumourous mass in the retrorbita. A superior orbital approach was chosen as this offered direct access to enucleate the lesion that was unsheathing the nerve. The approach avoids major neurovascular structures, although the supratrochlear and supraorbital neurovascular bundles were visualised and preserved. The approach provides an intermediate location between extra and transcranial approaches, however does increase the chances of an unaesthetic scar. Pupil sparing oculomotor palsy is often due to infarction of the nerve and is associated with diabetes. Smaller pupils may be associated with Horner’s syndrome or diabetic neuropathy. Results: Postoperatively, the patient’s opthalmoplegia was markedly resolved and ptosis improved dramatically. Conclusions: We discuss a case of optic nerve sheath meningioma with associated oculomotor palsy subsequently treated by superior orbitotomy with osteotomy. We highlight oculomotor palsy as a rare presenting feature and the innovative treatment of
http://dx.doi.org/10.1016/j.ijom.2017.02.614 Smoking and radiation history are significantly associated with osteosynthesis-associated delayed complications in free fibula reconstruction of mandible — a retrospective study S. Gokavarapu ∗ , Y.M. Chen, T. Ji, C.P. Zhang Department of Oral and Maxillofacial – Head and Neck Oncology, Shanghai Stomatology Key Laboratory, Ninth People’s Hospital School of Medicine, Shanghai Jiao Tong University School of Medicine, China Background: The osseous reconstruction after resection is the ideal choice for functional rehabilitation of mandible. Although the success rate of vascular fee fibula is high, late complications such as plate exposures and infections related to osteosynthesis are not uncommon. The choice of the type of dental rehabilitation is greatly influenced by such complications and defining risk factors are needed.