• Korean Journal of Head & Neck Oncology
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• v.37 no.2
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• pp.105-109
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• 2021

Follicular thyroid carcinoma (FTC) is the second most common thyroid cancer, following papillary carcinoma. Metastasis to the orbital rim from FTC is very rare. We recently experienced a case of FTC with metastasis to the orbital rim in a 74-year-old woman, who initially presented with a huge thyroid mass and an asymptomatic solitary orbital rim lesion. The solitary orbital rim lesion was suspected to be a separate disease entity such as lymphoma from the preoperative imaging, but bone metastasis from FTC was finally confirmed after orbital rim resection and total thyroidectomy. During follow-up, the patient presented multiple bone metastasis, so the solitary orbital rim lesion was considered a clinical sign of systemic metastasis from FTC. Therefore, we present this unique case with a review of the literature.

• Archives of Craniofacial Surgery
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• v.19 no.3
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• pp.214-217
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• 2018

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.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.11 no.1
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• pp.261-266
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• 1989

This study was undertaken to compare those 4 most commonly used incisions for exposure of fractures of the infraorbital rim and the orbital floor. The patient's age ranged from 19 to 67 years, the majority being in the 2nd decade. There were 17males and 1 female. Three orbital rim, 5 lower eyelid, 7 subciliary and 3 combined conjunctival-lateral canthotomy incisions were reviewed. Following points were the summury of author's experience. 1. The average scar following any of four incisions is barely noticeable. 2. Adequate fracture exposure was achieved with lower eyelid, orbital rim, subciliary and combined conjunctival-lateral canthotomy incisions. 3. One transient ectropion following subciliary incision occurred in 29-years old man with prolonged postoperative eyelid edema.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.40
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• pp.42.1-42.5
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• 2018

Background: Fractures of the orbital wall are mainly caused by traffic accidents, assaults, and falls and generally occur in men aged between 20 and 40 years. Complications that may occur after an orbital fracture include diplopia and decreased visual acuity due to changes in orbital volume, ocular depression due to changes in orbital floor height, and exophthalmos. If surgery is delayed too long, tissue adhesion will occur, making it difficult to improve ophthalmologic symptoms. Thus, early diagnosis and treatment are important. Fractures of the superior orbital wall are often accompanied by skull fractures. Most of these patients are unable to perform an early ocular evaluation due to neurosurgery and treatment. These patients are more likely to show tissue adhesion, making it difficult to properly dissect the tissue for wall reconstruction during surgery. Case presentation: This report details a case of superior orbital wall reconstruction using superior orbital rim osteotomy in a patient with a superior orbital wall fracture involving severe tissue adhesion. Three months after reconstruction, there were no significant complications. Conclusion: In a patient with a superior orbital wall fracture, our procedure is helpful in securing the visual field and in delamination of the surrounding tissue.

• Archives of Craniofacial Surgery
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• v.21 no.4
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• pp.219-224
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• 2020

Background: Repair of the orbital floor following trauma or tumor removal remains a challenge because of its complex three-dimensional shape. The purpose of the present study is to understand normal orbital floor anatomy by investigating its differences across four groups (Caucasian American and East Asian, males and females) via facial bone computed tomography (CT). Methods: A total of 48 orbits in 24 patients between 20 and 60 years of age were evaluated. Although most patients underwent CT scanning following trauma, the orbital walls were intact in all patients. Linear and angular measurements of the orbital floor were obtained from CT images. Results: Orbital floor width, length, angle between the orbital floor and medial wall, and distance from the inferior orbital rim to the lowest point of the orbital floor did not show a statistically significant difference between groups. Angles made by the infraorbital rim, the lowest point of the floor, and the anterior border of the infraorbital fissure were statistically significantly wider in East Asian females than in male groups. The floor depth in East Asian females was significantly smaller compared to all the other groups. Conclusion: East Asian female population had smaller curvature and depth of an orbital floor than the other groups, which means racial and sex-related differences should be considered in the orbital floor reconstruction.

• Archives of Craniofacial Surgery
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• v.11 no.1
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• pp.33-36
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• 2010

Purpose: Brown's syndrome is characterized by the limited elevation in adduction from mechanical causes around the superior oblique tendon trochlea complex. In this particular case, post-traumatic facial deformity accompanied by Brown's syndrome was observed. We would like to report the satisfying cosmetic results obtained by reconstructing orbital roof and superior orbital rim and repositioning of zygoma. Methods: A 12-year-old patient was observed with facial deformity with strabismus in her right eye and orbital dystopia after the car accident and was eventually diagnosed with traumatic Brown's syndrome. Reconstructive surgeries could not be performed at the time of trauma due to the cerebral hemorrhage. At the second year after the trauma, a depressed fracture of the right orbital roof and superior orbital rim were reconstructed via the intracranial approach, and orbital dystopia was corrected via the zygoma triple ostectomy. In addition, a strabismus surgery was performed one year after her plastic surgery. Results: Facial deformity with orbital dystopia and strabismus was confirmed to be fully reconstructed after the surgery. Moreover, when the patient came in for a follow-up thirteen years after the operation, a developmental imbalance of the facial bones, diplopia, or any other surgical complications were not to be found. Conclusion: After the trauma, the patient with Brown's Syndrome accompanied by post-traumatic facial deformity, who went under the corrective surgeries after the meticulous examination and assessment pre-surgically, was able to acquire cosmetic satisfaction via those operations.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.20 no.4
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• pp.373-378
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• 1998

In the midfacial fracture, the orbital region presents many additional complication unique to the orbit. Among them are ectropion, entropion, lid ptosis, injury to the lacrimal apparatus, diplopia or the late development of enophthalmos. The residual problem confronting the surgen is usually enophthalmos or diplopia. Enophthalmos becomes cosmetically obvious at 3mm and if more severe it can interfere with vision from obstruction by the orbital rim. In this clinical situation, many patients prefer the simpler intraorbital volume expansion to the more complex orbital osteotomy. In general, except in mild cases of enophthalmos, the procedure of choice is osteotomy and repositioning for zygoma fracture and volume augmentation for blow-out fracture. Late treatment is performed by volume augmentation based on the CT findings behind the axis of the globe. Inferiorly placed grafts elevate the globe, posterior superior grafts move the globe anterior and medially positioned grafts push the globe laterally. In this two cases, the patients who has stable orbitozygomatic rim, the use of calvarial bone grafts more than 3 areas around intraorbital content, we corrected late enophthalmos combined with diplopia. As result, the first patient had 2mm advance in exophthalmometric check with improvement of the diplopia gradually. The second patient had 1.5mm advance with correction of vertical ocular dystopia and cosmetically good results respectively.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.18 no.1
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• pp.17-25
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• 1996

There are many reports of the surgical management for the craniofacial abnormalities arising from the irradiation of the head and face for treatment of childhood cancers. Since the mordern combined-modality theraphy for childhood cancers began in the late 1960s and the early 1970s, recent reports have described the occular, dental and maxillo-facial abnormalities after irradiation in long-term survivors of cancers of the head and face. The resultant deformities may be known to be difficult to reconstruct with surgical techniques. This paper describes the late reconstructive surgery for the unilateral orbital and malar hypoplasia after eyeball enucleation and irradiation during childhood to correct the facial asymmetry and expand the contracted orbital socket into the functional dimension for the retaining eyeball prosthesis with spherical implant. We reports the satisfactory preliminary results from the midfacial osteotomy through the supero-lateral orbital rim and malar bone and the antero-lateral repositioning with the autogenous bone grafting in 26 year-old female patient who will be planned to make the new eyeball prosthesis by the department of ophthalmology.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.37 no.6
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• pp.524-529
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• 2011

Orbital roof and supraorbital ridge fractures are frequently associated with high energy concomitant craniofacial trauma. When a displacement of the orbital roof and supraorbital rim occurs, exploration, stabilization and reconstruction are warranted to limit the ocular complications. The management of fractures involving the frontal sinus must consider the possible need for obliteration or cranialization of the sinus. Many incisions have been described and used to approach these fractures, such as a coronal incision, eyebrow incision, and an incision through the laceration. We report 3 cases of orbital roof and supraorbital ridge fracture patients with a review of the relevant literature.

• Archives of Craniofacial Surgery
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• v.17 no.2
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• pp.77-81
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• 2016

Background: Asymmetry of the infraorbital rim can be caused by trauma, congenital or acquired disease, or insufficient reduction during a previous operation. Such asymmetry needs to be corrected because the shape of the infraorbital rim or midfacial skeleton defines the overall midfacial contour. Methods: The study included 5 cases of retruded infraorbital rim. All of the patient underwent restoration of the deficient volume using polyethylene implants between June 2005 and June 2011. The infraorbital rim was accessed through a subciliary approach, and the implants were placed in subperiosteal space. Surgical outcomes were evaluated using preoperative and postoperative computed tomography studies. Results: Implant based augmentation was associated with a mean projection of 4.6 mm enhancement. No postoperative complications were noted during the 30-month follow-up period. Conclusion: Because of the safeness, short recovery time, effectiveness, reliability, and potential application to a wide range of facial disproportion problems, this surgical technique can be applied to midfacial retrusion from a variety of etiologies, such as fracture involving infraorbital rim, congenital midfacial hypoplasia, lid malposition after blepharoplasty, and skeletal changes due to aging.