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Clinical outcome after orbital floor fracture reduction with special regard to patient's satisfaction

Chinese Journal of Traumatology 2019年第3期22卷 155-160页

作者： Stefan Hartwig Marie-Christine Nissen Jan Oliver Voss christian doll Nicolai Adolphs Max Heiland Jan Dirk Raguse Department for Oral and Maxillofacial and Facial Plastic Surgery Johannes Wesling Hospital MindenUniversity Hospital of the Ruhr University BochumGermany Charite-Universitatsmedizin Berlin Corporate Member of Freie Universitat BerlinHumboldt-Universitat zu Berlinand Berlin Institute of HealthDepartment of Oral and Maxillofacial SurgeryGermany

Purpose: Primary reconstruction via transconjunctival approach is a standardized treatment option for orbital floor fractures. The aim of this study was to compare the findings of specific ophthalmologic assessment with the patient's complaints after fracture reduction. Methods: A retrospective medical chart analysis was performed on patients who had undergone transconjunctival orbital floor fracture reduction for fracture therapy with resorbable foil (ethisorb sheet or polydioxanone foil). A follow-up assessment including ophthalmological evaluation regarding visual acuity (eye chart projector), binocular visual field screening (Bagolini striated glasses test) and diplopia (cover test, Hess screen test) was conducted. Additionally, a questionnaire was performed to assess patients' satisfaction. Results: A total of 53 patients with a mean follow-up of 23 months (ranging from 11 to 72) after surgical therapy were included. Diplopia was present preoperatively in 23 (43.4%) and reduced in follow-up examination (n = 12, 22.6%). Limitations in ocular motility reduced from 37.7% to 7.5%. The questionnaire about the patient's satisfaction revealed excellent outcomes in relation to the functional and esthetical parameters. Conclusion: Transconjunctival approach is a safe approach for orbital fracture therapy. Postoperative diplopia is nearly never perceptible for the individual and differs to pathologic findings in the ophthalmic assessment.

关键词： Orbital floor fractures Blow out fractures Transconjunctival approach Clinical outcome

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Perinatal testicular torsion—An emergency with grave consequences

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Case Reports in Clinical Medicine 2013年第1期2卷 66-69页

作者： Dietrich doll Josef Erkel Thomas Erhart christian Honemann Department of Surgery Marienhospital VechtaAcademic Teaching Hospital of the Hannover UniversityVechtaGermany Department of Visceral Thoracic and Vascular SurgeryPhilipps-University of MarburgMarburgGermany Department of Neonatology and Pediatric Care Marienhospital VechtaAcademic Teaching Hospital of the Hannover UniversityVechtaGermany Department of Anaesthesiology and Intensive Care Marienhospital VechtaAcademic Teaching Hospital of the Hannover UniversityVechtaGermany

Introduction: Perinatal testicular torsion is not a frequent, but a grave finding finding. As only immediate surgical retorsion may save the viability of the testicle, time is of essence. We report the case of a newborn where delayed diagnosis led to an unnecessary loss of one testicle. Presentation of Case: The newborn was presented one day after delivery with a swollen left blue scrotal pouch. The left testicle was little tender, higher in position and enlarged. Ultrasound revealed a globular, enlarged testicle left, showing hypodense necrotic areas within. Doppler sound could not detect any perfusion of the spermatic vessels. Scrotal fluid was present bilaterally. At operation, the testicle was considered unsalvageable, and left orchiectomy and right orchidopexy were performed. Discussion: In the new-born, it is more than convenient to perfom ultrasound of both testicles at the same time, which allows to compare texture and perfusion easily. Immediate surgical exploration should be performed at any time, even if in diagnostic doubt. The very most important step though is to professionally recognise and to react to this pediatric emergency, as time is of paramount essence. Conclusion: A case of a male newborn with unilateral perinatal testicular torsion is presented, where typical clinical signs and ultrasound features can be seen. Early exploration with orchiectomy of the necrotic testicle and orchidopexy of the healthy side may save the endocrine function and fertility.

关键词： Neonatal Perinatal Testicular Torsion Testicular Necrosis Orchidopexy Acute Scrotal Swelling

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