Endoscopic repair of orbital floor fractures /certified fixed orthodontic courses by Indian dental academy

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The Indian Dental Academy is the Leader in continuing dental education , training dentists in all aspects of dentistry and offering a wide range of dental certified courses in different formats.

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Endoscopic repair of orbital floor fractures /certified fixed orthodontic courses by Indian dental academy

  1. 1. ENDOSCOPIC REPAIR OF ORBITAL FLOOR FRACTURES www.indiandentalacademy.com
  2. 2. INDIAN DENTAL ACADEMY Leader in continuing dental education www.indiandentalacademy.com www.indiandentalacademy.com
  3. 3. CONTENTS           INTRODUCTION ORBITAL FLOOR FRACTURES TREATMENT MODALITIES ENDOSCOPE&PARTS HISTORY INDICATIONS ADVANTAGES DISADVANTAGES CONCLUSION REFERENCES www.indiandentalacademy.com
  4. 4. INTRODUCTION  ORBITAL FLOOR FRACTURES PRESENT WITH SIGNIFICANT PROBLEMS WHICH REQUIRE PROPER ATTENTION AND MANAGEMENT.  THERE ARE VARIOUS MODES OF MANAGEMENT WITH THEIR OWN ADVANTAGES AND LIMITATIONS www.indiandentalacademy.com
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  6. 6. CLINICAL FEATURES  EYELID EDEMA  CIRCUMORBITAL ECCHYMOSIS  SUBCONJUNCTIVAL       HEMORRHAGE ALTERATION OF VISUAL AXIS PARESTHESIA DIPLOPIA ENOPTHALMOS RESTRICTION OF OCULAR MOVEMENT EPISTAXIS www.indiandentalacademy.com
  7. 7. TREATMENT  MEDICAL THERAPY  SURGERY 1) conventional surgery 2) endoscopy www.indiandentalacademy.com
  8. 8. Access to orbital floor# :  Lateral & medial eyebrow  Crows feet , existing laceration  Subciliary or blepheroplasty  Infraorbital , medial canthal  Transconjunctival, bicoronal  Transnasal , antral , buccal sulcus www.indiandentalacademy.com
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  10. 10. DISADVANTAGES OF CONVENTIONAL SURGERY:  Post operative lid malposition  Lid shortening  Entropion  Ectropion  Limited visibility of posterior orbit www.indiandentalacademy.com
  11. 11. NEED FOR ENDOSCOPE  POOR VISUALISATION OF POSTERIOR EDGE OF FRACTURE INVOLVING POSTERIOR PORTION OF FLOOR.  INABILITY TO SEE THE CONDITION OF THE HERNIATED TISSUE BEFORE REDUCTION  HELPS TO CONFIRM THAT ALL THE SOFT TISSUES HAVE BEEN ELEVATED FROM THE FRACTURE SITE. www.indiandentalacademy.com
  12. 12. ENDOSCOPE:  An instrument used to examine the interior of a hollow organ or cavity of the body.  Unlike other medical imaging devices endoscopes can be directly inserted in to an organ.  Can be used succesfully in various fields of medicine both as diagnostic tool or for treatment. www.indiandentalacademy.com
  13. 13. HISTORY  Philip Bozzini in 1806 -developed first endoscope.  William beaumont in 1822-first introduced endoscope in to human body.  Karl storz in 1945-started producing endoscopes to ENT surgeons. www.indiandentalacademy.com
  14. 14. PARTS:  A rigid or flexible tube  A light delivery system to illuminate the organ or object under inspection  A lens system transmitting image to the viewer from the fiberscope  An additional channel to allow entry of medical instruments or to manipulate www.indiandentalacademy.com
  15. 15. INDICATIONS:  Patients with 1) Trap door fracture 2) Medial blow out fractures 3) Lateral blow out fractures NOTE: Fractures extending lateral to infraorbital nerve or involving lamina papyracea are difficult to repair endoscopically. www.indiandentalacademy.com
  16. 16. ENDOSCOPIC APPROACHES  TRANS NASAL  TRANS ANTRAL  INTRA ORAL www.indiandentalacademy.com
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  20. 20. ADVANTAGES:  Improved visualisation  Anatomic fracture repair  No risk of post operative eyelid complications  Good clinical results  Increased illumination  Video projection for rest of the surgical team&documentation  Precise and complete reduction of herniated soft tissues  Correct implant placement www.indiandentalacademy.com
  21. 21. DISADVANTAGES:  PRESENCE OF ORBITAL FAT INTERFERES      WITH INTRAORBITAL USE OF ENDOSCOPE TECHNIQUE SENSITIVE TRAINED PERSONNEL REQUIRED NOT ECONOMICAL CAN BE USED IN SOME PARTICULARS CASES ONLY. NEED OF SURGERY IN CASE OF FAILURE. www.indiandentalacademy.com
  22. 22. COMPLICATIONS:  INFRAORBITAL PARESTHESIA  POST OPERATIVE SINUSITIS  PERSISTENT DIPLOPIA www.indiandentalacademy.com
  23. 23. CONCLUSION:  THE REPAIR OF ORBITAL FLOOR FRACTURE IS PEREFORMED SUCCESSFULLY USING ENDOSCOPES IN MANY CENTERS.  IT IS TECHNICALLY DEMANDING AND REQUIRE AN EXPERTISE IN USING ENDOSCOPE.  IT APPEARS A PROMISING NEW TECHNIQUE FOR ISOLATED TRAP DOOR AND MEDIAL FLOOR FRACTURES. www.indiandentalacademy.com
  24. 24. REFERENCES  Br.journalof plastic surgery ;jan 57(1)57(1)37 (1)37 -44  Endoscopic orbital floor repair J. of craniofacial surgery.2008 jan  Clinical recommendations for repair of isolated orbital floor fracture,M.Burnstine.opthalmology2002 vol109,(7),1207-1210  Lester Mc,blow out fractures of orbit ;br.j.plastic surgery,1965(18);171  Otolaryngol Clin North Am. 2007 Apr;40(2):31928 www.indiandentalacademy.com
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