- Browse by Author
Browsing by Author "Chan, David"
Now showing 1 - 4 of 4
Results Per Page
Sort Options
Item Extra-ocular movement restriction and diplopia following orbital fracture repair(Elsevier, 2017) Shah, H. A.; Shipchandler, Taha; Vernon, Dominic; Baumanis, Maraya; Chan, David; Nunery, William R.; Lee, Hui Bae Harold; Department of Otolaryngology -- Head and Neck Surgery, School of MedicinePurpose To report a series of patients with extra-ocular movement restriction and diplopia after orbital fracture repair, and determine the effect of timing of repair and the type of implant used. Methods A chart review was conducted identifying all patients > 18 years of age at our institution between June 2005 and June 2008 who underwent orbital fracture repair, and presented with clinically significant diplopia and extra-ocular movement restriction persisting longer than one month after repair. Data collected included timing of repair, implant used within the orbit, and need for revision. Results Ten patients were identified with a mean time to primary orbital fracture repair at 9 days (range 1–48). Seven patients underwent revision of their orbital fracture repair with removal of the previously placed implant and replacement with non-porous 0.4 mm Supramid Foil, whereas one patient underwent lateral and inferior rectus recessions without revision of primary fracture repair. Titanium mesh was the intra-orbital implant found in all patients requiring revision of orbital fracture repair. All revisions resulted in resolution of clinically significant diplopia. Conclusions Clinically significant diplopia and extra-ocular movement restriction is not an uncommon complication after orbital fracture repair. In our series, there was a strong association between these complications and the use of porous titanium mesh implants. Revision of fractures significantly improved diplopia in all but one patient. This suggests that meticulous fracture repair and the use of non-porous implants primarily or secondarily may preclude the need for strabismus surgery after orbital trauma.Item Repair of the Malpositioned Lower Lid(Thieme, 2017) Chan, David; Sokoya, Mofiyinfolu; Ducic, Yadranko; Otolaryngology -- Head and Neck Surgery, School of MedicineComplications from surgical approaches to the orbit can be associated with debilitating morbidity and negative surgical outcomes. The surgeon must be familiar with the different factors that predispose a patient to these complications and be facile with techniques to avoid them. In this article, the authors discuss the surgical anatomy of the lower eyelid, as well as various complications that result from eyelid surgery, including lower lid retraction, ectropion, entropion, canthal malposition, and midface descent. They also discuss various management techniques that are employed in addressing these complications.Item Scar Revision: Surgical and Nonsurgical Options(Thieme, 2017) Kadakia, Sameep; Ducic, Yadranko; Jategaonkar, Ameya; Chan, David; Otolaryngology -- Head and Neck Surgery, School of MedicineFacial scarring represents a challenging issue for the facial plastic surgeon owing to the unpredictable and variable nature of scar formation. The psychologic, cosmetic, and functional implications of facial scars oftentimes necessitate revision. It is important for the facial plastic surgeon to be aware of the invasive and noninvasive options to best educate patients in terms of treatment modalities. As there are multiple options available with no single option touted as superior, management of expectations and patient motivation will allow for realistic treatment planning with the greatest change of success.Item Update on the Evidence for Functional Rhinoplasty Techniques(Lippincott Williams & Wilkins, 2015-08) Chan, David; Shipchandler, Taha Z.; Department of Otolaryngology Head & Neck Surgery, IU School of MedicinePurpose of review: Functional rhinoplasty is a term that is commonly used to describe any technique used to address nasal obstruction in the nasal valve region. The cause of nasal valve collapse differs based on the site. Internal valve collapse may be idiopathic or associated with previous rhinoplasty, trauma, or weakened cartilage in older patients. External valve collapse is usually idiopathic and less likely to be associated with previous surgery. Various techniques have been developed over time, and the data in support of functional rhinoplasty continue to increase. Recent findings: This article discusses popular techniques currently in use, as well as newer techniques that have been described over the past several years. In addition, there is a trend toward utilizing objective testing and validated assessment scales to assess postoperative changes. Summary: Functional rhinoplasty utilizes a multitude of techniques to address nasal valve collapse. Although high-level data are lacking, the current literature is in support of nasal valve correction to improve nasal breathing. Most importantly, the technique employed is unique for each patient.