학술논문
Estado del arte en la reconstrucción de los traumatismos de las paredes orbitarias
Document Type
Dissertation/Thesis
Author
Source
TDX (Tesis Doctorals en Xarxa)
Subject
Language
Spanish; Castilian
Abstract
1.Tenemos menos fracturas orbitarias y estas son de menor energía. 2.La tendencia actual es a ser mucho más conservador en el manejo de la patología traumática orbitaria. Los defectos tipo I si no hay repercusión clínica a nivel de la motilidad ocular, no deben de reconstruirse ya que el beneficio estético no justifica la morbilidad del abordaje quirúrgico. 3.Las mallas de titanio son, en el momento actual, el método de elección para los defectos de paredes orbitarias tipo II y tipo III. Han demostrado una biocompatibilidad extraordinaria y un comportamiento seguro y fidedigno a largo plazo. 4.Los estudios tomográficos a largo tiempo demuestran una remodelación y neoformación ósea de las paredes orbitarias en los casos reconstruidos con implantes de titanio. 5.Los estudios cadavéricos y la clínica tardía de los pacientes confirman que el abordaje transconjuntival extendido a transcaruncular es un abordaje seguro a la pared medial siempre que se discurra en un plano retroseptal. 6.La desinserción del músculo oblicuo menor puede realizarse en los casos seleccionados para la reconstrucción de grandes defectos de las paredes orbitarias y que no produce un incremento de la diplopia. 7.El tipo de fractura es el factor que más afecta a la diplopia postoperatoria.
The epidemiological analysis of the orbital trauma shows a change in the most prevalent etiology in these last 17 years. 1.We have less orbital fractures and these fractures have less energy. . 2.La current trend is to be more conservative in the management of traumatic orbital pathology. Type I defects, if there is no clinical impact in terms of ocular motility, should not be operated, because the aesthetic benefit does not justify the morbidity of the surgical approach. 3.The titanium mesh are, at present, the ideal reconstructive material for orbital wall defects type II and type III. They have demonstrated extraordinary biocompatibility, are safe and reliable in the long-term. 4.Late tomographic studies show osseous remodeling and neoformation in the orbital walls in cases reconstructed with titanium implants. 5. Cadaveric and late clinical studies, confirm that the transconjunctival approach extended to transcaruncular is a safe approach to the medial wall whenever it proceeds within a retroseptall plane. 6.Inferior oblique muscle detachment can be performed in selected cases for the reconstruction of large defects of the orbital wall, and does not produce an increase in diplopia. 7. The type of fracture is the factor that most affects the postoperative diplopia
The epidemiological analysis of the orbital trauma shows a change in the most prevalent etiology in these last 17 years. 1.We have less orbital fractures and these fractures have less energy. . 2.La current trend is to be more conservative in the management of traumatic orbital pathology. Type I defects, if there is no clinical impact in terms of ocular motility, should not be operated, because the aesthetic benefit does not justify the morbidity of the surgical approach. 3.The titanium mesh are, at present, the ideal reconstructive material for orbital wall defects type II and type III. They have demonstrated extraordinary biocompatibility, are safe and reliable in the long-term. 4.Late tomographic studies show osseous remodeling and neoformation in the orbital walls in cases reconstructed with titanium implants. 5. Cadaveric and late clinical studies, confirm that the transconjunctival approach extended to transcaruncular is a safe approach to the medial wall whenever it proceeds within a retroseptall plane. 6.Inferior oblique muscle detachment can be performed in selected cases for the reconstruction of large defects of the orbital wall, and does not produce an increase in diplopia. 7. The type of fracture is the factor that most affects the postoperative diplopia