International journal of oral and maxillofacial surgery
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Int J Oral Maxillofac Surg · Nov 2016
Case ReportsEmergency management for orbital compartment syndrome-is decompression mandatory?
Current guidelines for the urgent management of patients with orbital compartment syndrome include immediate lateral canthotomy and cantholysis, followed by surgical decompression. Medical treatment is also advocated to 'buy time' while preparing the patient for theatre. This consists of high-dose steroids, mannitol, and acetazolamide diuretics to reduce swelling and orbital pressure. ⋯ The case of a patient who sustained an orbital trauma to his only seeing eye, which resulted in acute proptosis and loss of vision, is presented here. He received no treatment at all for what appeared to be an orbital compartment syndrome secondary to retrobulbar haemorrhage, but surprisingly made a full recovery of vision within 48h. In contrast to the current literature in favour of urgent treatment, this case would appear to cast some doubt over the concept of 'always' treating orbital compartment syndrome and our understanding of the condition.
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Int J Oral Maxillofac Surg · Nov 2016
Application of digital surgical guides in mandibular resection and reconstruction with fibula flaps.
Surgical guides have been used widely in maxillofacial surgery. Details of the types of digital surgical guide used in mandibular resection and reconstruction with fibula flaps at the authors' institution are presented in this article. ⋯ These digital surgical guides included a mandibular osteotomy guide, a fibular osteotomy guide, and a mandibular fixation guide. Surgical guides are helpful in improving the accuracy of operations and are appropriate for many types of mandibular resection and reconstruction.