Degree of Swelling of the Medial Rectus Muscle on CT Images to Differentiate Old From New Medial Orbital Wall Fracture
ABSTRACT The aims of this study were to compare the degree of swelling of the medial rectus muscle (MR) in a recent fracture group, an old fracture group, and a normal group and to use this to differentiate old medial orbital wall fracture from recent fracture.We made measurements of the computed tomography images of 43 patients with a recent medial orbital wall fracture (the recent fracture group), 46 patients with depression of the medial wall and who were without a recent trauma history (the old fracture group), and 86 patients who were without any facial injury (the normal group). On the axial view, the width of the MR was measured bilaterally, and the width ratio to the contralateral side was calculated. On the coronal view, the height of the MR was measured bilaterally, and the height ratio to the contralateral side was calculated. The width-to-height ratio was also measured on the involved side.The width ratio of the recent fracture group was 1.42 ± 0.31, and it was significantly higher than that of the old fracture group (1.25 ± 0.15) or the normal group (1.00 ± 0.09). The width ratio of the old fracture group was also significantly higher than that of the normal group. The height ratio of the normal group (1.00 ± 0.04) was significantly higher than that of the recent fracture group (0.91 ± 0.15) or the old fracture group (0.86 ± 0.07). The height ratio of the recent fracture group was also significantly higher than that of the old fracture group (P = 0.043). The width-height ratio of the recent fracture group (0.63 ± 0.23) was significantly higher than that of the old fracture group (0.55 ± 0.09) or the normal group (0.37 ± 0.05). The height-to-width ratio of the old fracture group was also significantly higher than that of the normal group.We think the width ratio of the MR of the injured side to the MR of the contralateral side can be the better parameter to differentiate a recent fracture from an old fracture.
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ABSTRACT: The aim of this study was to see how frequently depression of the orbital medial wall can be found on computed tomographic (CT) imaging of patients without a recent trauma event.A total of 14,628 CT scans (12,515 brain CT scans and 2113 three-dimensional facial CT scans) of patients with no recent trauma event (defined as a facial trauma within 1 mo) were reviewed. If there was a depression of more than 3 mm on the medial wall compared with the contralateral side in the axial view, the scan was included in the "depression or asymmetry" group. In the depression or asymmetry group, old fractures and recent fractures were differentiated according to the degree of swelling of the medial rectus muscle and soft tissue swelling.Among the 14,628 CT scans with no recent facial trauma event, 836 cases (5.7%) had depression or an asymmetric medial wall. Most (94.3%, 788 cases) of the 836 cases were discovered to have an old medial wall fracture, whereas 39 cases (4.7%) were reported to have a recent medial wall fracture despite not having a recent facial trauma event. Only 9 cases (1.1%) were revealed to have a mucocele.It is noteworthy that 5.3% (788 cases among the 14,628 cases) had an old medial wall fracture despite not having any facial trauma within 1 month. The reason for this relatively high ratio is thought to be because medial fractures are often undetected with conventional plain x-ray imaging.Journal of Craniofacial Surgery 08/2014; 25(5). DOI:10.1097/SCS.0000000000001060 · 0.68 Impact Factor
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ABSTRACT: Introduction: Biomaterial-based scaffold formulations (three-dimensional Porous matrix, nano-fibre mesh, hydrogels and microspheres) are the major components that are used to deliver the bioactive molecules into the body organs through different routes for an effective treatment of various diseases. Areas covered: Various fabrication techniques such as freeze-drying, polymerisation, spray drying, gas foaming, supercritical fluid technology, etc., are successfully used for fabrication of scaffold formulations. Due to their unique characteristics, these formulations are widely used against various diseases such as tuberculosis, bone defects, cartilage repair, skin diseases, cardiovascular diseases, periodontal diseases, wound dressing, etc. Expert opinion: The study of biomaterial-based scaffold formulations is exhilarating with novel approaches to drug/cell/gene delivery being developed all the time. At present, there is a huge extent of research being performed worldwide on all aspects of tissue engineering/drug or gene delivery. In the future, the main focus will be on the development of more patient compliant, sustained and controlled delivery systems against various diseases by modification of polymers, manufacturing technologies as well as carrier systems.Expert Opinion on Drug Delivery 03/2014; DOI:10.1517/17425247.2014.891014 · 4.12 Impact Factor