• Title/Summary/Keyword: Eyeball Movement

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Reconstruction of the Inferior Orbital Wall with Simplified Simulation Technique in Case of the Fracture Extending to the Posterior Orbital Floor

  • Kim, Kyu Nam;Kim, Hoon
    • Journal of International Society for Simulation Surgery
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    • v.3 no.2
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    • pp.80-83
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    • 2016
  • A 37-year-old male was assaulted and complained of severe periorbital swelling. Physical examination revealed that there were limitation of eyeball movement on upper gaze, diplopia, and hypoesthesia on the infraorbital nerve innervating region. Three-dimensional (3D) computed tomography (CT) of facial bone exhibited the fracture of orbital floor accompanying the significant amount of orbital contents' herniation extending to the far posterior part. To recover the orbital volume and restore orbital floor without threatening the optic nerve, preoperative simplified simulation was applied. The posterior margin of the fractured orbit was delineated with simulation technique using cross-linkage between the coronal and sagittal sections based on the referential axial view of the CT scans. Dissection, reduction of orbital contents, and insertion of the absorbable mesh plate molded after the prefabricated template by the simulation technique was performed. Extensive orbital floor defect was successfully reconstructed and there were no serious complications. The purpose of this report is to emphasize the necessity of preoperative simulation in case of restoring the extensive orbital floor defect.

Pediatric Orbital Medial Wall Trapdoor Fracture with Normal Computed Tomography Findings

  • Lee, Hyun Rok;Jung, Gyu Yong;Lee, Dong Lark;Shin, Hea Kyeong
    • Archives of Craniofacial Surgery
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    • v.18 no.2
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    • pp.128-131
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    • 2017
  • With advances in diagnostic technology, radiologic diagnostic methods have been used more frequently, and physical examination may be neglected. The authors report a case of pediatric medial orbital trapdoor fracture in which the surgery was delayed because computed tomography (CT) findings did not indicate bone displacement, incarceration of rectus muscle, or soft tissue herniation. A healthy 6-year-old boy was admitted to the emergency room for right eyebrow laceration. We could not check eyeball movement or diplopia, because the patient was irritable. Thus, we performed facial CT under sedation, but there was normal CT finding. Seven days later, the patient visited our hospital due to persistent nausea and dizziness. We were able to perform a physical examination this time. Lateral gaze of right eye was limited. CT still did not show any findings suggestive of fracture, but we decided to perform exploratory surgery. We performed exploration, and found no bone displacement, but discovered entrapped soft tissue. We returned the soft tissue to its original position. The patient fully recovered six weeks later. To enable early detection and treatment, thorough physical examination and CT reading are especially needed when the patient shows poor compliance, and frequent follow-up observations are also necessary.

Case Report of Three Cases of Idiopathic Oculomotor Nerve Palsy Treated with Hominis Placenta Pharmacopuncture (특발성 동안신경마비의 자하거 약침 치료 3례)

  • Jung, Ki-Hun;Kim, Min-Seok;Hwang, Hee-Sang;Jeon, Jae-Cheon;Park, Jae-Yeon;Lee, Tae-Ho;Lee, Eun-Yong;Roh, Jeong-Du
    • Journal of Pharmacopuncture
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    • v.12 no.1
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    • pp.91-97
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    • 2009
  • Objective : Oculomotor nerve palsy is a disorder which causes eyeball movement trouble, diplopia, dizziness and eyelid ptosis. It is caused by aneurysm, mass, trauma, infection and so on. But sometimes we can't establish the cause. We observed 3 cases of idiopathic oculomotor nerve palsy patient treated with hominis placenta pharmacopuncture. Method & Result : We treated three idiopathic oculomotor nerve palsy patients with hominis placenta pharmacopuncture and electroacupuncture. As the result, symptoms of three patients were improved remarkably. Conclusion : In this cases, the hominis placenta pharmacopuncture is effective on idiopathic oculomotor nerve palsy. We need further study about idiopathic oculomotor nerve palsy and hominis placenta pharmacopuncture.

Endoscopic slide-in orbital wall reconstruction for isolated medial blowout fractures

  • Kim, Taewoon;Kim, Baek-Kyu
    • Archives of Craniofacial Surgery
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    • v.21 no.6
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    • pp.345-350
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    • 2020
  • Background: This study evaluated the efficacy of the endoscopic medial orbital wall repair by comparing it with the conventional transcaruncular method. This surgical approach differs from the established endoscopic technique in that we push the mesh inside the orbit rather than placing it over the defect. Methods: We retrospectively reviewed 40 patients with isolated medial orbital blowout fractures who underwent medial orbital wall reconstruction. Twenty-six patients underwent endoscopic repair, and 14 patients underwent external repair. All patients had preoperative computed tomography scans taken to determine the defect size. Pre- and postoperative exophthalmometry, operation time, the existence of diplopia, and pain were evaluated and compared between the two methods. We present a case showing our procedure. Results: The operation time was significantly shorter in the endoscopic group (44.7 minutes vs. 73.9 minutes, p= 0.035). The preoperative defect size, enophthalmos correction rate, and pain did not significantly differ between the two groups. All patients with preoperative diplopia, eyeball movement limitation, or enophthalmos had their symptoms resolved, except for one patient who had preexisting strabismus. Conclusion: This study demonstrates that endoscopic medial orbital wall repair is not inferior to the transcaruncular method. The endoscopic approach seems to reduce the operation time, probably because the dissection process is shorter, and no wound repair is needed. Compared to the previous endoscopic method, our method is not complicated, and is more physiological. Larger scale studies should be performed for validation.

A Case Report: Korean Medicine Treatment for Miller-Fisher Syndrome with Ophthalmoplegia (밀러-피셔 증후군의 외안근 마비에 대한 한의학적 치험 1례)

  • Kim, Hae-yoong;Kim, Jeong-hui;Won, Seo-young;Yoo, Ho-ryong;Seol, In-chan;Kim, Yoon-sik
    • The Journal of Internal Korean Medicine
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    • v.43 no.4
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    • pp.761-768
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    • 2022
  • The purpose of this case report was to document the efficacy of Korean medicine as a treatment for Ophthalmoplegia of Miller-Fisher Syndrome. A 57-year-old male patient was treated with acupuncture, electropuncture, pharmacopuncture, and cupping treatments for 2 months. Symptom changes were evaluated using the Scott and Kraft score, photographs of eyeball movement, and the Yanagihara score. Korean medicine treatment significantly improved the eye movements, ncreased the Scott and Kraft score from -4 to 0, and improved the Yanagihara score from 20 to 32. Korean medicine treatment could effectively and quickly treat Ophthalmoplegia of Miller-Fisher Syndrome.

Limited eye movement caused by clumping of fibrin glue used in blowout fracture surgery: a care report

  • Shin, Jin Yong;Lee, Nae-Ho;Kim, Min-Seok;Roh, Si-Gyun;Chung, Yoon Kyu
    • Archives of Craniofacial Surgery
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    • v.23 no.5
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    • pp.228-231
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    • 2022
  • Fibrin glue is a topical agent widely used for hemostasis, wound healing, and surgical adhesion. Complications of fibrin glue itself are extremely rare because it is absorbed over time, but can occur as a result of inappropriate application. We report a case of a postoperative complication caused by inappropriate application of fibrin glue in blow-out fracture surgery. A 65-year-old male patient presented with periorbital swelling and an open wound on the right infraorbital area. Computed tomography showed a right orbital floor fracture. After reduction of the herniated tissue into the orbit, an implant was inserted and fibrin glue was applied to stabilize the implant. This procedure was performed without difficulty, but the patient complained of persistent diplopia and limited eyeball movement after surgery. An imaging study showed a mass-like lesion, which was not a hematoma, in the orbital cavity. In a second operation, the mass was identified as clotted fibrin glue that had not been applied properly. After removal, the patient's symptoms were relieved without further complications. Appropriate and careful application of fibrin glue is necessary to avoid unnecessary complications.

Development of Intelligent Learning Tool based on Human eyeball Movement Analysis for Improving Foreign Language Competence (외국어 능력 향상을 위한 사용자 안구운동 분석 기반의 지능형 학습도구 개발)

  • Shin, Jihye;Jang, Young-Min;Kim, Sangwook;Mallipeddi, Rammohan;Bae, Jungok;Choi, Sungmook;Lee, Minho
    • Journal of the Institute of Electronics and Information Engineers
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    • v.50 no.11
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    • pp.153-161
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    • 2013
  • Recently, there has been a tremendous increase in the availability of educational materials for foreign language learning. As part of this trend, there has been an increase in the amount of electronically mediated materials available. However, conventional educational contents developed using computer technology has provided typically one-way information, which is not the most helpful thing for users. Providing the user's convenience requires additional off-line analysis for diagnosing an individual user's learning. To improve the user's comprehension of texts written in a foreign language, we propose an intelligent learning tool based on the analysis of the user's eyeball movements, which is able to diagnose and improve foreign language reading ability by providing necessary supplementary aid just when it is needed. To determine the user's learning state, we correlate their eye movements with findings from research in cognitive psychology and neurophysiology. Based on this, the learning tool can distinguish whether users know or do not know words when they are reading foreign language sentences. If the learning tool judges a word to be unknown, it immediately provides the student with the meaning of the word by extracting it from an on-line dictionary. The proposed model provides a tool which empowers independent learning and makes access to the meanings of unknown words automatic. In this way, it can enhance a user's reading achievement as well as satisfaction with text comprehension in a foreign language.

Clinical significance of saccade test, smooth pursuit test, and optokinetic nystagmus test in nystagmography (안진검사에서 단속운동검사, 시추적검사, 시운동성 안진검사의 임상적 의의)

  • Choi, Yoon Seok;Na, Hyung Gyun;Song, Si-Youn;Kim, Yong-Dae;Bae, Chang Hoon
    • Journal of Yeungnam Medical Science
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    • v.34 no.1
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    • pp.29-36
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    • 2017
  • Background: Saccade test, smooth pursuit test, and optokinetic nystagmus test are clinically useful tests to accurately diagnose vertigo. However, there have only been a few studies regarding a correlation between the anatomical site of the lesion and the abnormality of eyeball movement in patients with vertigo. Methods: The medical records of 97 patients with vertigo between January 2006 and June 2008 were reviewed retrospectively. We classified many kinds of abnormalities regarding the saccade test, smooth pursuit test and optokinetic nystagmus test into several categories and analyzed the localizing lesion of vertigo. Results: According to the saccade test, both total saccade abnormality (S-total) and slow velocity of saccade (S-type 3) were shown to be significantly higher in the central lesion of vertigo. According to the smooth pursuit test, symmetrical unidirectional smooth pursuit abnormality (SP-type 2) was observed to be significantly higher in the peripheral lesion over vertigo. Moreover, according to the optokinetic nystagmus test, total optokinetic nystagmus abnormalities (OKN-total) were shown to be significantly useful findings in the diagnosis of the central lesion of vertigo. The coexisting abnormalities of all three tests (S+SP+OKN abnormalities) were shown to be significantly higher in the central lesion of vertigo. Conclusion: These results suggest that all these tests, saccade test, smooth pursuit test, and optokinetic nystagmus test, are very useful to distinguish between the central lesion and the peripheral lesion of vertigo. However, these tests are not beneficial in localizing the central lesion of vertigo.

Treatment of Blow-out Fractures Using Both Titanium Mesh Plate and Porous Polyethylene (Medpor®) (광범위한 안와파열골절에서 Titanium Mesh Plate와 Porous Polyethylene (Medpor®) 동시 사용의 유용성)

  • Gu, Ja Hea;Won, Chang Hoon;Dhong, Eun-Sang;Yoon, Eul-Sik
    • Archives of Craniofacial Surgery
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    • v.11 no.2
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    • pp.85-90
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    • 2010
  • Purpose: The goals of a blow-out fracture reconstruction are to restore the osseous continuity, provide support for the orbital contents and prevent functional and anatomic defects. Over the past several years, a range of autogenous and synthetic implants have been used extensively in orbital reconstructions. None of these implants have any absolute indications or contraindications in certain clinical settings. However, in extensive blow-out fractures, it is difficult to restore support of the orbital contents, which can cause more complications, such as enophthalmos. This study examined the clinical outcomes of extensive or comminuted blow-out fractures that were reconstructed by the simultaneous use of a titanium mesh plate and $Medpor^{(R)}$. Methods: Eighty six patients with extensive orbital fractures, who were admitted between March 1999 and February 2007, were reviewed retrospectively. The patients' chart and CT were inspected for review. Twenty three patients were operated on with both a titanium mesh plate (Matrix MIDFACE pre-formed orbital plate, Synthes, USA) and $Medpor^{(R)}$ (Porex, GA, USA). The patients underwent pre-operative CT scans to evaluate the fracture site and measure the area of the fracture. A transconjunctival approach was used, and titanium mesh plates were inserted subperiosteally with screw fixation. $Medpor^{(R)}$ was inserted above the titanium mesh plate. The patients were evaluated post-operatively for enophthalmos, diplopia, sensory disturbances and eyeball movement for a period of at least 6 months. Results: No implant-related complications were encountered during the follow-up period. Enophthalmos occurred in 1 patient, 1 patient had permanent sensory disturbance, and 3 patients complained of ocular pain and fatigue, which recovered without treatment. Although there were no significance differences between groups, the use of 2 implants had fewer complications. Therefore, it can be an alternative method for treating blow out fractures. Conclusion: The use of both a titanium mesh plate and $Medpor^{(R)}$ simultaneously may be a safe and acceptable technique in the reconstruction of extensive blow-out fractures.

EFFECTS OF THE SITE AND THE EXTENT OF BLOWOUT FRACTURE ON ENOPHTHALMOS AND DIPLOPIA (Blowout 골절의 부위와 정도가 안구함몰 및 복시에 미치는 영향)

  • Hwang, Ung;Ryu, Sun-Youl
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.30 no.4
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    • pp.292-300
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    • 2004
  • Orbital blowout fractures are common consequence to blunt periorbital trauma. Pure orbital blowout fractures first occur at the weakest point of the orbital wall. Computed tomography(CT) is recognized to be the best imaging technique to evaluate orbital fractures. The extent and location of a blowout fractures in the CT scan were noted to have an effect on the clinical outcome. In the early posttraumatic period, the presence of significant enophthalmos is difficult to detect because of orbital edema. Early surgical intervention may improve the ultimate outcome because open reconstruction becomes more difficult if surgery is delayed. In this study, we evaluated isolated blowout fractures of the orbital floor by region-of-interest measurements from CT scans and their relationship to ophthalmologic findings. Six patients of the medial orbital wall fractures, eleven patients of the inferior orbital wall fractures, nineteen of the medial and the inferior orbital wall fractures confirmed by CT scan, were evaluated. The area of fracture and the volume of the displaced orbital tissue were determined from CT scan using linear measurements. Each of the calculated values for the area and the volume were compared with the degree of the enophthalmos, the diplopia, and the eyeball movement limitation to determine whether there was any significant relationship between them. The fracture area and the volume of the herniated orbital tissue were significantly positively correlated with the enophthalmos and the ocular motility limitation and not correlated with the diplopia. For the enophthalmos of 2mm or greater, the mean fracture area was 3.55{\pm}1.25cm^2$ and the volume of the herniated orbital tissue was $1.74{\pm}0.97cm^3$; for less than 2mm enophthalmos, $1.43{\pm}0.99cm^3$ and $0.52{\pm}0.49cm^3$, respectively. The enophthalmos of 2mm can be expected with $2.92cm^2$ of the fracture area and $1.40cm^3$ of the herniated orbital tissue. In conclusion, the enophthalmos of 2mm or more, which is a frequent indication for surgery. It can be expected when area of fracture is $2.92cm^2$ or more, or the volume of herniated orbital tissue is $1.40cm^3$ or more. And the CT scan using linear measurements has an application in the assessment of patients with blowout fractures and provides useful information in the posttraumatic evaluation of orbital fractures.