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Title
1. Introduction
2. Surgical Approach
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a. Inject 1% Lidocaine with 1:100,000 Epinephrine
3. Transconjunctival Approach to the Orbital Floor and Removal of Infected Implant
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a. Start with Lateral Canthotomy
b. Create Transconjunctival Incision While Preserving Tarsus
4. Exposure of Entire Orbital Floor Defect and Preparation for New Implant
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a. Expose Stable Remaining Medial Orbital Wall
b. Estimate Length and Shape of Implant
5. Placement of New Orbital Floor Implant
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a. Use Malleables to Retract Orbital Content Superiorly; Prepare for Implant Placement
b. For Complex Revision Cases, Use Neuronavigation to Check for Implant Positioning
c. Secure Implant with Screws
6. Examine and Consider Opening Up Maxillary Sinus
7. Closure
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a. Address Eyelid Fistula Site
b. Close Transconjunctival Incision
c. Close Lateral Canthotomy
d. Resuspend Lateral Canthus
8. Post-op Remarks
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Neuronavigation and Endoscopy as Adjunctive Tools in Orbital Floor Implant Revision: Surgical Management of Infected, Misplaced Orbital Floor Implant with Chronic Eyelid Fistula and Sinusitis
Derek Sheen, MD
1
;
Cheryl Yu, MD
2
;
Sarah Debs, MD
2
;
Katherine M. Yu, MD
2
;
Alyssa N. Calder, MD
2
;
Kevin J. Quinn, MD
3
;
Dimitrios Sismanis, MD
4
;
Thomas Lee, MD, FACS
2
1
University of Texas Southwestern Medical Center
2
Virginia Commonwealth University Medical Center
3
Mass Eye and Ear/Harvard Medical School
4
Virginia Oculofacial Surgeons
Tags:
Otolaryngology
Oral and Maxillofacial Surgery (OMFS)
Ophthalmology
Main Text
Procedure Outline
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Authors
Derek Sheen, MD
Cheryl Yu, MD
Sarah Debs, MD
Katherine M. Yu, MD
Alyssa N. Calder, MD
Kevin J. Quinn, MD
Dimitrios Sismanis, MD
Thomas Lee, MD, FACS
Filmed At:
VCU Medical Center
Article Information
Publication Date
1/10/2024
Article ID
410
Production ID
0410
Volume
2024
Issue
410
DOI
https://doi.org/10.24296/jomi/410