TY - JOUR
T1 - A stepwise approach to chainsaw kickback injury of the nasoorbital complex
T2 - a case-based meta-narrative review
AU - Pitak-Arnnop, Poramate
AU - Nimitwongsakul, Ornvenus
AU - Sirintawat, Nattapong
AU - Subbalekha, Keskanya
AU - Stoll, Christian
AU - Meningaud, Jean Paul
N1 - Publisher Copyright:
© 2024 The Authors
PY - 2024/7
Y1 - 2024/7
N2 - Purpose: This article outlines the management of a rare and severe nasoorbital injury resulting from a chainsaw kickback accident in a 60-year-old male. A meta-narrative review of English, French, and German literature indexed in PubMed, Embase, and the Cochrane Library up to January 8, 2024, accompanies the case report. Methods: This was a case report combined with a comprehensive review based on the 2011 Oxford Centre for Evidence-Based Medicine's highest and most recent level of evidence (LoE) and highest recommendation grade (RG). Rigorous selection criteria were applied. Results: The patient had an open nasal fracture, complex lacerations, and avulsion of the left eyelid, lateral orbital wall and lateral rectus muscle. Staged surgical interventions comprised repositioning and fixation of the fractured nose, buccal mucosal grafting for nasal mucosa and conjunctiva repair, titanium mesh and polydioxanone sheet for lateral orbital wall reconstruction, and subsequent muscle and eyelid repair. The second intervention 3 months postsurgery addressed lateral ectropion, nasal dorsal hump, and nasolacrimal system issues. Despite the rarity of such injuries, evidence-based discussions were conducted. Conclusions: Complex nasoorbital trauma resulting from chainsaw kickback necessitates a meticulous, staged surgical approach. The inside-out technique proved effective in addressing various challenges. This article concludes with evidence-based recommendations, highlighting the importance of adapting established principles to unique nature of these injuries.
AB - Purpose: This article outlines the management of a rare and severe nasoorbital injury resulting from a chainsaw kickback accident in a 60-year-old male. A meta-narrative review of English, French, and German literature indexed in PubMed, Embase, and the Cochrane Library up to January 8, 2024, accompanies the case report. Methods: This was a case report combined with a comprehensive review based on the 2011 Oxford Centre for Evidence-Based Medicine's highest and most recent level of evidence (LoE) and highest recommendation grade (RG). Rigorous selection criteria were applied. Results: The patient had an open nasal fracture, complex lacerations, and avulsion of the left eyelid, lateral orbital wall and lateral rectus muscle. Staged surgical interventions comprised repositioning and fixation of the fractured nose, buccal mucosal grafting for nasal mucosa and conjunctiva repair, titanium mesh and polydioxanone sheet for lateral orbital wall reconstruction, and subsequent muscle and eyelid repair. The second intervention 3 months postsurgery addressed lateral ectropion, nasal dorsal hump, and nasolacrimal system issues. Despite the rarity of such injuries, evidence-based discussions were conducted. Conclusions: Complex nasoorbital trauma resulting from chainsaw kickback necessitates a meticulous, staged surgical approach. The inside-out technique proved effective in addressing various challenges. This article concludes with evidence-based recommendations, highlighting the importance of adapting established principles to unique nature of these injuries.
UR - http://www.scopus.com/inward/record.url?scp=85189706726&partnerID=8YFLogxK
U2 - 10.1016/j.oooo.2024.02.004
DO - 10.1016/j.oooo.2024.02.004
M3 - Article
AN - SCOPUS:85189706726
SN - 2212-4403
VL - 138
SP - e1-e12
JO - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
JF - Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology
IS - 1
ER -