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Terms in this set (4)
Used to identify paretic muscle from entrapped muscle.
Topical anesthetic and grab tissue at limbus.
Ask patient to look in direction being examined and globe is then rotated in the same direction. Degree of restriction is noted.
May be most helpful intraop done at the beginning and after reduction and plating.
Indications for surgical repair of orbital floor fracture
Symptomatic persistent diplopia with positive forced ductions, CT evidence of orbital tissue or muscle entrapment, and no clinical improvement over 1-2 weeks.
Early enophthalmos or significant globe ptosis.
Floor defect of greater than 50%
Associated rim or facial fractures.
Blow-in fracture with fragments pushing on nerve or muscles in the orbit.
Oculocardiac reflex (N/V, bradycardia) needs more urgent repair
Herniation of globe into maxillary sinus is indication for emergent repair.
Preferably repair within 2 weeks, but wait 7-10d for edema to improve.
Medial orbital wall repair
Similar to floor repair with transconj approach, may need transcanalicular approach as well.
May need to detatch inferior oblique to put implant in. No need to reattach.
Often need to fixate the plate - should be done posterior to the orbital rim.
Management of orbital roof fracture
Minimally or nondisplaced fractures not involving frontal sinus may be observed.
Isolated CSF leak may be observed for 1 week for spontaneous resolution, persistent may require dural repair.
Fractures involving anterior wall of frontal that are nondisplaced can be observed. If displaced, need repair.
Minimally or nondisplaced posterior table fracture with CSF leak can be monitored closely +/- lumbar drain.
Persistent leak treated with cranialization.
Displaced posterior wall without CSF leak but compromised outflow tract needs obliteration or cranialization.
THIS SET IS OFTEN IN FOLDERS WITH...
Vestibular and Balance disorders
Neck spaces and fascial planes
Facial plastic surgery
Congenital hearing loss
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Allergy and immunology
Reconstructive head and neck surgery