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Sample records for orbital blowout fracture

  1. Orbital Wall Restoring Surgery for Inferomedial Blowout Fracture.

    PubMed

    Lim, Nam Kyu; Kang, Dong Hee; Oh, Sang Ah; Gu, Ja Hea

    2015-11-01

    Repairing a large inferomedial blowout fracture remains a challenge to orbital surgeon. The authors restored the fracture using combined transnasal and transorbital approaches using support of both paranasal sinuses. The authors compared surgical results of this novel method with those of the traditional procedure. Of 106 inferomedial blowout fracture patients who underwent surgical treatment between March 2007 and July 2013, 50 patients were selected in our study: 25 patients underwent the traditional procedure as controls, and the other 25 patients underwent orbital wall restoring surgery by our combined approach. Outcomes were evaluated in terms of the orbital volume ratio (OVR) and changes in Hertel scale. The OVR in the experimental group (7.19%) decreased more significantly than in the control group (2.71%) (P < 0.05). In conclusion, the orbit was restored more successfully following orbital wall restoring surgery with dual support than by using the traditional inferomedial blowout fracture procedure. PMID:26595000

  2. Considerations for the Management of Medial Orbital Wall Blowout Fracture

    PubMed Central

    Park, Youngsoo; Chung, Kyu Jin

    2016-01-01

    Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes. PMID:27218019

  3. Considerations for the Management of Medial Orbital Wall Blowout Fracture.

    PubMed

    Kim, Yong-Ha; Park, Youngsoo; Chung, Kyu Jin

    2016-05-01

    Recently, diagnoses of and operations for medial orbital blowout fracture have increased because of the development of imaging technology. In this article, the authors review the literature, and overview the accumulated knowledge about the orbital anatomy, fracture mechanisms, surgical approaches, reconstruction materials, and surgical methods. In terms of surgical approaches, transcaruncular, transcutaneous, and transnasal endoscopic approaches are discussed. Reconstruction methods including onlay covering, inlay implantation, and repositioning methods are also discussed. Consideration and understanding of these should lead to more optimal outcomes. PMID:27218019

  4. Orbital Wall Restoring Surgery in Pure Blowout Fractures

    PubMed Central

    Lim, Nam Kyu; Oh, Sang Ah; Gu, Ja Hea

    2014-01-01

    Background Restoring orbital volume in large blowout fractures is still a technically challenge to the orbital surgeon. In this study, we restored the orbital wall using the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses, and we compared the surgical outcome to that of a conventional transorbital method. Methods A retrospective review of all patients with pure unilateral blowout fractures between March 2007 and March 2013 was conducted. 150 patients were classified into two groups according to the surgical method: conventional transorbital method (group A, 75 patients, control group), and the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses (group B, 75 patients, experimental group). Each group was subdivided depending on fracture location: group I (inferior wall), group IM (inferomedial wall), and group M (medial wall). The surgical results were assessed by the Hertel scale and a comparison of preoperative and postoperative orbital volume ratio (OVR) values. Results In the volumetric analysis, the OVR decreased more by the experimental groups than each corresponding control groups (P<0.05). Upon ophthalmic examination, neither the differences among the groups in the perioperative Hertel scale nor the preoperative and postoperative Hertel scales were statistically significant (P>0.05). Conclusions Our surgical results suggest that orbital volume was more effectively restored by the combination of transorbital and transnasal approach with additional supports from the paranasal sinuses than the conventional method, regardless of the type of fracture. PMID:25396181

  5. The Merits of Mannitol in the Repair of Orbital Blowout Fracture

    PubMed Central

    Shin, Kyung Jin; Lee, Dong Geun; Park, Hyun Min; Choi, Mi Young; Bae, Jin Ho

    2013-01-01

    Background One of the main concerns in orbital blowout fracture repair is a narrow operation field, due mainly to the innate complex three dimensions of the orbit; however, a deep location and extensive area of the fracture and soft tissue edema can also cause concern. Swelling of the orbital contents progresses as the operation continues. Mannitol has been used empirically in glaucoma, cerebral hemorrhage, and orbital compartment syndrome for decompression. The authors adopted mannitol for the control of intraorbital edema and pressure in orbital blowout fracture repair. Methods This prospective study included 108 consecutive patients who were treated for a pure blowout fracture from January 2007 to October 2012. For group I, mannitol was administered during the operation. Under general anesthesia, all patients underwent surgery by open reduction and insertion of an absorbable mesh implant. The authors compared postoperative complications, the reoperation rate, operation time, and surgical field improvement between the two groups. Results In patients who received intraoperative administration of mannitol, the reoperation rate and operation time were decreased; however, the difference was not statistically significant. The total postoperative complication rates did not differ. Panel assessment for the intraoperative surgical field video recordings showed significantly improved vision in group I. Conclusions For six years, mannitol proved itself an effective, reliable, and safe adjunctive drug in the repair of orbital blowout fractures. With its rapid onset and short duration of action, mannitol could be one of the best methods for obtaining a wider surgical field in blowout fracture defects. PMID:24286045

  6. Current concepts on the management of orbital blow-out fractures.

    PubMed

    Koornneef, L

    1982-09-01

    Surgical versus nonsurgical treatment of orbital blow-out fractures has been controversial in the past. In the 1950s it was advocated that all blow-out fractures be treated surgically based on the conception that extraocular muscles were blown out and trapped in the fracture hole, causing double vision and enophthalmos. Gradually, however, a shift to a more conservative approach occurred, probably because of the complications of surgery, the disappointing results in improvement of motility and enophthalmos, and the growing evidence of spontaneous improvement of double vision. This article analyzes the literature chronologically and blends this analysis with the results of a new anatomical approach to the human orbit. New theories on the mechanism of blow-out fractures are postulated. No longer is entrapment of muslces in a blow-out fracture held responsible for the severe motility problems; rather it is viewed as caused by a dysfunction of the entire motility apparatus in the fracture region. Consequently, conventional surgical treatment, repairing the orbital floor only, seems to have lost its theoretical foundation and a conservative approach is advocated until microsurgical techniques become more readily avaliable to treat the sequelae of blow-out fractures at their origin. PMID:7137815

  7. Application of endoscopic techniques in orbital blowout fractures.

    PubMed

    Zhang, Shu; Li, Yinwei; Fan, Xianqun

    2013-09-01

    Minimally invasive surgical techniques, particularly endoscopic techniques, have revolutionized otolaryngeal surgery. Endoscopic techniques have been gradually applied in orbital surgery through the sinus inferomedial to the orbit and the orbital subperiosteal space. Endoscopic techniques help surgeons observe fractures and soft tissue of the posterior orbit to precisely place implants and protect vital structures through accurate, safe, and minimally invasive approaches. We reviewed the development of endoscopic techniques, the composition of endoscopic systems for orbital surgery, and the problems and developmental prospects of endoscopic techniques for simple orbital wall fracture repair. PMID:23794028

  8. Reconstruction using 'triangular approximation' of bone grafts for orbital blowout fractures.

    PubMed

    Saiga, Atsuomi; Mitsukawa, Nobuyuki; Yamaji, Yoshihisa

    2015-10-01

    There are many orbital wall reconstruction materials that can be used in surgery for orbital blowout fractures. We consider autogenous bone grafts to have the best overall characteristics among these materials and use thinned, inner cortical tables of the ilium. A bone bender is normally used to shape the inner iliac table to match the orbital shape. Since orbital walls curve three-dimensionally, processing of bone grafts is not easy and often requires much time and effort. We applied a triangular approximation method to the processing of bone grafts. Triangular approximation is a concept used in computer graphics for polygon processing. In this method, the shape of an object is represented as combinations of polygons, mainly triangles. In this study, the inner iliac table was used as a bone graft, and cuts or scores were made to create triangular sections. These triangular sections were designed three-dimensionally so that the shape of the resulting graft approximated to the three-dimensional orbital shape. This method was used in 12 patients with orbital blowout fractures, which included orbital floor fractures, medial wall fractures, and combined inferior and medial wall fractures. In all patients, bone grafts conformed to the orbital shape and good results were obtained. This simple method uses a reasonable and easy-to-understand approach and is useful in the treatment of bone defects in orbital blowout fractures when using a hard graft material. PMID:26297418

  9. A case of blowout fracture of the orbital floor in early childhood

    PubMed Central

    Sugamata, Akira; Yoshizawa, Naoki

    2015-01-01

    There are few reports of blowout fractures of the orbital floor in children younger than 5 years of age; in a search of the literature, we found only six reported cases which revealed the exact age, correct diagnosis, and treatment. We herein report the case of a 3-year-old boy with a blowout fracture of the orbital floor. Computed tomography showed a pure blowout fracture of the left orbital floor with a slight dislocation of the orbital contents. The patient was treated conservatively due to the absence of abnormal limitation of eye movement or enophthalmos. The patient did not develop any complications that necessitated later surgical intervention. Computed tomography at 6 months after the injury showed the regeneration of the orbital floor in the area of the fracture and no abnormalities in the left maxillary sinus. We herein present our case and the details of six other cases reported in the literature, and discuss their etiology, diagnosis, and treatment methods. PMID:26251631

  10. A case of blowout fracture of the orbital floor in early childhood.

    PubMed

    Sugamata, Akira; Yoshizawa, Naoki

    2015-01-01

    There are few reports of blowout fractures of the orbital floor in children younger than 5 years of age; in a search of the literature, we found only six reported cases which revealed the exact age, correct diagnosis, and treatment. We herein report the case of a 3-year-old boy with a blowout fracture of the orbital floor. Computed tomography showed a pure blowout fracture of the left orbital floor with a slight dislocation of the orbital contents. The patient was treated conservatively due to the absence of abnormal limitation of eye movement or enophthalmos. The patient did not develop any complications that necessitated later surgical intervention. Computed tomography at 6 months after the injury showed the regeneration of the orbital floor in the area of the fracture and no abnormalities in the left maxillary sinus. We herein present our case and the details of six other cases reported in the literature, and discuss their etiology, diagnosis, and treatment methods. PMID:26251631

  11. Treatment of orbital blowout fracture using porous polyethylene with embedded titanium.

    PubMed

    Qian, Zhuyun; Zhuang, Ai; Lin, Ming; Li, Zhengkang; Ge, Shengfang; Fan, Xianqun

    2015-03-01

    The study was performed to evaluate the effectiveness and safety of porous polyethylene with embedded titanium in the repair of orbital blowout fracture. The study was designed as a prospective case series. Patients who were diagnosed with orbital blowout fracture from May 2012 to March 2013 were included in the study. A composite material of porous polyethylene and titanium mesh was used. Orbital volumes before and after surgery were measured, and the results of diplopia and ocular movement were recorded. The occurrence of diplopia was grouped and compared according to the time interval between injury and surgery. The incidence of other complications was also recorded. A total of 26 patients were involved in the study. The minimal follow-up time was 12 months. All surgeries were performed uneventfully. The orbital volume significantly decreased after the surgery, and the remission rate and the elimination rate of diplopia in 12 months were 85.7% and 47.6%, respectively. Postoperative diplopia was correlated with the time interval between injury and surgery. One patient presented with undercorrection of enophthalmos, and another patient presented with acute aggravation of diplopia and exophthalmos after surgery, which was resolved with treatment. In conclusion, porous polyethylene with embedded titanium was effective and safe in the repair of orbital blowout fracture, and studies with more subjects and longer follow-up period are recommended in future studies. PMID:25699530

  12. Delayed Superior Orbital Fissure Syndrome After Reconstruction of Blowout Fracture.

    PubMed

    Kim, Young Joon; Choi, Woong Kyu

    2016-01-01

    The superior orbital fissure syndrome (SOFS) has been known to be a condition caused by impairment of the nerves that cross the superior orbital fissure. Traumatic SOFS is an uncommon complication which occurs usually within 48 hours after a facial injury. A 25-year-old male sustained facial trauma following an altercation. Clinical findings on presentation included swelling, ecchymosis, hyphema, subretinal hemorrhage, and mild extraocular movement limitation upon lateral gaze on his right eyelids. Facial computed tomography scan confirmed fractures of the medial walls of the right orbit and herniation of orbital soft tissue without the incarceration of medial rectus muscle. Ten days after the trauma, the operation was performed. On postoperative day 16, the patient showed ptosis of the right upper eyelid with a fixed pupil, and there was a hypoesthesia over the distribution of the right supraorbital and supratrochlear nerves. The authors diagnosed as a delayed SOFS and prescribed 4 mg of methylprednisolone q.i.d. for 30 days. After steroid therapy, extraocular movement limitations improved progressively. After 8 months, movement was completely restored. The authors experienced delayed SOFS on posttrauma day 27, and it was treated by steroid therapy. Surgical intervention is required when there is an evident etiology such as underlying hematoma or plate migration. If the reason is not clear like our case, steroid therapy can be considered as one of the options. Particularly, the authors should give special attention to the patient who has congenitally narrow superior orbital fissure, like Fujiwara et al suggested. PMID:26674904

  13. Diplopia of pediatric orbital blowout fractures: a retrospective study of 83 patients classified by age groups.

    PubMed

    Su, Yun; Shen, Qin; Lin, Ming; Fan, Xianqun

    2015-01-01

    Orbital blowout fractures are relatively rare in patients under 18 years of age, but may lead to serious complications. We conducted this retrospective study to evaluate diplopia, clinical characteristics, and postoperative results in cases of orbital blowout fractures in the pediatric population. Eighty-three patients, all less than 18 years old, with orbital blowout fractures, were divided into 3 groups by age: 0 to 6 years old, 7 to 12 years old, and 13 to 18 years old. The cause of injury, fracture locations, diplopia grades, ocular motility restrictions, enophthalmos, and postoperative results were reviewed from their records. Chi-square tests, Fisher's exact analyses, analyses of variance, and logistic regressions were performed to determine characteristics associated with diplopia, and to identify factors related to residual diplopia in pediatric patients. The most common causes of injuries were traffic accidents in the 0 to 6 years old group, normal daily activities in the 7 to 12 years old group, and assaults in the 13 to 18 years old group. Floor fractures were the most common location in both the 0 to 6- and 7 to 12 years old groups, and medial-floor fractures were the most common location in the 13 to 18 years old group. The occurrence of preoperative diplopia was related to ocular motility restriction and enophthalmos, but not with the age group, the gender, the cause of injury, or the fracture locations. The time interval from injury to surgery was significant in the outcome of postoperative diplopia (P < 0.01). A statistical difference was also found in the recovery time from diplopia among the 3 age groups (P < 0.01). The characteristics of orbital blowout fracture varied among the different age groups. It was related to 2 factors, the cause of injury and fracture locations, which probably resulted from structural growth changes and differences in daily habits. Children had a slower recovery from orbital fractures, and the younger the

  14. Diplopia of Pediatric Orbital Blowout Fractures: A Retrospective Study of 83 Patients Classified by Age Groups

    PubMed Central

    Su, Yun; Shen, Qin; Lin, Ming; Fan, Xianqun

    2015-01-01

    Abstract Orbital blowout fractures are relatively rare in patients under 18 years of age, but may lead to serious complications. We conducted this retrospective study to evaluate diplopia, clinical characteristics, and postoperative results in cases of orbital blowout fractures in the pediatric population. Eighty-three patients, all less than 18 years old, with orbital blowout fractures, were divided into 3 groups by age: 0 to 6 years old, 7 to 12 years old, and 13 to 18 years old. The cause of injury, fracture locations, diplopia grades, ocular motility restrictions, enophthalmos, and postoperative results were reviewed from their records. Chi-square tests, Fisher's exact analyses, analyses of variance, and logistic regressions were performed to determine characteristics associated with diplopia, and to identify factors related to residual diplopia in pediatric patients. The most common causes of injuries were traffic accidents in the 0 to 6 years old group, normal daily activities in the 7 to 12 years old group, and assaults in the 13 to 18 years old group. Floor fractures were the most common location in both the 0 to 6- and 7 to 12 years old groups, and medial-floor fractures were the most common location in the 13 to 18 years old group. The occurrence of preoperative diplopia was related to ocular motility restriction and enophthalmos, but not with the age group, the gender, the cause of injury, or the fracture locations. The time interval from injury to surgery was significant in the outcome of postoperative diplopia (P < 0.01). A statistical difference was also found in the recovery time from diplopia among the 3 age groups (P < 0.01). The characteristics of orbital blowout fracture varied among the different age groups. It was related to 2 factors, the cause of injury and fracture locations, which probably resulted from structural growth changes and differences in daily habits. Children had a slower recovery from orbital fractures, and the younger

  15. The Hydraulic Mechanism in the Orbital Blowout Fracture Because of a High-Pressure Air Gun Injury.

    PubMed

    Kang, Seok Joo; Chung, Eui Han

    2015-10-01

    There are 2 predominant mechanisms that are used to explain the pathogenesis of orbital blowout fracture; these include hydraulic and buckling mechanisms. Still, however, its pathophysiology remains uncertain. To date, studies in this series have been conducted using dry skulls, cadavers, or animals. But few clinical studies have been conducted to examine whether the hydraulic mechanism is involved in the occurrence of pure orbital blowout fracture. The authors experienced a case of a 52-year-old man who had a pure medial blowout fracture after sustaining an eye injury because of a high-pressure air gun. Our case suggests that surgeons should be aware of the possibility that the hydraulic mechanism might be involved in the blowout fracture in patients presenting with complications, such as limitation of eye movement, diplopia, and enophthalmos. PMID:26468824

  16. Orthoptic Sequelae Following Conservative Management of Pure Blowout Orbital Fractures: Anecdotal or Clinically Relevant?

    PubMed

    Steinegger, Ken; De Haller, Raoul; Courvoisier, Delphine; Scolozzi, Paolo

    2015-07-01

    The aim of this study was to prospectively assess the prevalence of orthoptic anomalies following conservative management of pure blowout orbital fractures and to evaluate their clinical relevance. Clinical and radiologic data of patients with unilateral conservatively managed pure blowout orbital fractures with a minimum follow-up of 6 months were reviewed. Eligible patients were contacted and invited to undergo an extended ophthalmologic examination as follows: distance and near visual acuities, Hertel exophthalmometry, corneal light reflex (Hirschberg test), ductions and versions in the 6 cardinal fields of gaze, eye deviation with prisms and alternate cover test in all of the 9-gaze directions with Maddox rod, degrees of incyclo/excyclotorsion with right and left eye fixation, horizontal and vertical deviation with Hess-Weiss coordimetry, degree of horizontal/vertical and incyclo/excyclotorsion deviation with Harms wall deviometry, and vertical deviation with Bielschowsky head-tilt test. Of the 69 patients contacted, 49 declined to participate given that they were asymptomatic. Twenty patients agreed to undergo the examination. One patient complained of minimal double vision limited to the extreme downgaze. Four patients had asymptomatic ocular motility disturbances limited to the extreme gaze. Seven patients had asymptomatic horizontal heterophoria. These disturbances did not interfere with daily or professional activities in any of the patients. The current study demonstrated that conservative management of pure orbital blowout fractures can result in orthoptic anomalies. These sequelae were restricted to a very limited portion of the binocular field of the vision and were not found to be clinically relevant. PMID:26102539

  17. Pure orbital blowout fractures reconstructed with autogenous bone grafts: functional and aesthetic outcomes.

    PubMed

    Kronig, S A J; van der Mooren, R J G; Strabbing, E M; Stam, L H M; Tan, J A S L; de Jongh, E; van der Wal, K G H; Paridaens, D; Koudstaal, M J

    2016-04-01

    The purpose of this study was to investigate the ophthalmic clinical findings following surgical reconstruction with autogenous bone grafts of pure blowout fractures. A retrospective review of 211 patients who underwent surgical repair of an orbital fracture between October 1996 and December 2013 was performed. Following data analysis, 60 patients who were followed up over a period of 1 year were included. A solitary floor fracture was present in 38 patients and a floor and a medial wall fracture in 22 patients. Comparing preoperative findings between these two groups, preoperative diplopia and enophthalmos were almost twice as frequent in the group with additional medial wall fractures: diplopia 8% and 14% and enophthalmos 18% and 55%, respectively. One year following surgery there was no diplopia present in either group. In the solitary floor fracture group, 3% still had enophthalmos. It can be concluded that at 1 year following the repair of pure orbital floor fractures using autogenous bone, good functional and aesthetic results can be obtained. In the group with both floor and medial wall fractures, no enophthalmos was found when both walls were reconstructed. When the medial wall was left unoperated, 29% of patients still suffered from enophthalmos after 1 year. PMID:26711249

  18. Orbital blow-out fractures: correlation of preoperative computed tomography and postoperative ocular motility.

    PubMed Central

    Harris, G J; Garcia, G H; Logani, S C; Murphy, M L; Sheth, B P; Seth, A K

    1998-01-01

    BACKGROUND/PURPOSE: Although the management of orbital blow-out fractures was controversial for many years, refined imaging with computed tomography (CT) helped to narrow the poles of the debate. Many orbital surgeons currently recommend repair if fracture size portends late enophthalmos, or if diplopia has not substantially resolved within 2 weeks of the injury. While volumetric considerations have been generally well-served by this approach, ocular motility outcomes have been less than ideal. In one series, almost 50% of patients had residual diplopia 6 months after surgery. A fine network of fibrous septa that functionally unites the periosteum of the orbital floor, the inferior fibrofatty tissues, and the sheaths of the inferior rectus and oblique muscles was demonstrated by Koornneef. Entrapment between bone fragments of any of the components of this anatomic unit can limit ocular motility. Based on the pathogenesis of blow-out fractures, in which the fibrofatty-muscular complex is driven to varying degrees between bone fragments, some measure of soft tissue damage might be anticipated. Subsequent intrinsic fibrosis and contraction can tether globe movement, despite complete reduction of herniated orbital tissue from the fracture site. We postulated that the extent of this soft tissue damage might be estimated from preoperative imaging studies. METHODS: Study criteria included: retrievable coronal CT scans; fractures of the orbital floor without rim involvement, with or without extension into the medial wall; preoperative diplopia; surgical repair by a single surgeon; complete release of entrapped tissues; and postoperative ocular motility outcomes documented with binocular visual fields (BVFs). Thirty patients met all criteria. The CT scans and BVFs were assessed by different examiners among the authors. Fractures were classified into 3 general categories and 2 subtypes to reflect the severity of soft tissue damage within each category. "Trap-door" injuries

  19. Clinical and Radiologic Characteristics of Inferior Rectus Muscle Sheath Entrapment in Orbital Blowout Fracture.

    PubMed

    Bagheri, Abbas; Tavakoli, Mehdi; Khosravifard, Keivan; Yazdani, Shahin

    2015-10-01

    Blowout fracture is a common condition in the oculoplastics clinic. One of the indications for its repair is entrapment of the inferior rectus muscle within the fracture site. Herein, the authors present 3 patients of inferior rectus muscle sheath entrapment without entrapment of the muscle itself. The outcome of treatment was excellent in all patients. The aim of this report is to present the special clinical and radiologic findings in such patients. PMID:26413961

  20. Retroseptal Transconjunctival Approach for Blowout Fracture of the Orbital Floor: An Ideal Choice in East-Asian Patients

    PubMed Central

    Chuman, Takahiro; Fujii, Tatsuya; Morikawa, Aya; Kikuchi, Mamoru; Watanabe, Hidetaka

    2016-01-01

    Objective: To ask experts in the field to evaluate a surgeon’s experience with a retroseptal transconjunctival approach for the repair of the orbital floor damaged by blowout fracture that the surgeon encountered in 12 East-Asian patients. Methods: Patients were identified from a database, and a retrospective case note review was conducted. A total of 12 conjunctival procedures were conducted for the repair of blowout fracture with no other complicating fractures. All operative procedures were done by transconjunctival approach alone without lateral canthotomy or any other additional approach. Results: The repair of the orbital floor was successful in all the cases. Three patients had bone grafting to the orbital floor after reduction. The mean of overall surgical time was 48.8 minutes (range, 22–85 minutes) for orbit exposure by transconjunctival approach plus reduction and bone grafting when applicable. There were 6 urgent surgeries associated with missing or entrapment of the inferior rectus muscle, and its repair took an average of 32.0 minutes (range, 22–41 minutes). Postoperative diplopia recovered at an average of 12.4 weeks (range, 0–60 weeks); in urgent cases, it took an average of 5.3 weeks (range, 0–14 weeks) before recovery. Conclusions: A retroseptal transconjunctival approach in repairing the orbital floor is a simple, easily manageable, and effective procedure, leaving no conspicuous facial scars. It has proved to be an optimal choice in blowout fracture cases, especially when there was urgency to decompress the ischemic inferior rectus muscle in as short a surgery time as possible. PMID:27579249

  1. Fixation of fractured inferior orbital wall using fibrin glue in inferior blowout fracture surgery.

    PubMed

    Jo, Eun Jun; Yang, Ho Jik; Kim, Jong Hwan

    2015-01-01

    The objectives of surgical treatment for orbital fracture are to return soft tissue to its original position as well as reduce and fix the bone fragments properly. Reduction of the orbital bone through a subciliary or conjunctival incision and reduction using a urinary balloon catheter were simultaneously performed on 53 patients between 2010 and 2013. Fibrin glue was used to attach the reduced bone fragments. These patients had less than 2 cm(2) of bone defect and showed diplopia, eye movement limitation, and enophthalmos. Diplopia, eye movement limitation, and enophthalmos were each reduced to 3/32, 2/25, and 2/48, respectively. There were no adverse effects, such as infection or hematoma, and because implants were not used, there was no possibility of its extrusion or foreign body reaction. The operation time decreased compared with when using an implant, and the bone fragments remained in a fixed position even after removing the urinary balloon catheter. Therefore, the use of fibrin glue proved to be effective in orbital floor fractures. PMID:25565237

  2. Survey of Common Practices among Oculofacial Surgeons in the Asia-Pacific Region: Management of Orbital Floor Blowout Fractures

    PubMed Central

    Koh, Victor; Chiam, Nathalie; Sundar, Gangadhara

    2014-01-01

    A web-based anonymous survey was performed to assess common practices of oculofacial surgeons in the management of traumatic orbital floor blowout fractures. A questionnaire which contained questions on several controversial topics in the management of orbital floor fractures was sent out via e-mail to 131 oculofacial surgeons in 14 countries in the Asia-Pacific region. A total response rate of 58.3% was achieved from May to December 2012. The preferred time for surgical intervention was within 2 weeks for adult patients, porous polyethylene implant was the most popular choice, and most surgeons preferred the transconjunctival approach. Postoperatively, diplopia was the most commonly encountered complication and most oculofacial surgeons reviewed their patients regularly for up to 12 months. We report the results of the first survey of oculofacial surgeons within the Asia-Pacific region on the management of orbital floor blowout fractures. Compared with previous surveys (from year 2000 to 2004), the duration to surgical intervention was comparable but there was a contrasting change in preferred surgical approach and choice of orbital implant. PMID:25136408

  3. Comparative Orbital Volumes between a Single Incisional Approach and a Double Incisional Approach in Patients with Combined Blowout Fracture

    PubMed Central

    Park, Sang Wook; Seo, Bommie F.; Rhie, Jong Won; Ahn, Sang Tae; Oh, Deuk Young

    2015-01-01

    Purpose. Blowout fracture characterized by concurrent floor and medial wall fractures is a rare entity. We compared surgical outcomes between a single approach and a double approach in patients with orbital fracture by measuring the postoperative orbital volume. Methods. We confirmed that 21 (8.5%) of a total of 246 patients with orbital fractures had fractures of the medial wall and floor through a retrospective chart review. Of these, 10 patients underwent the single approach and the remaining 11 patients had the double approach. We performed a statistical analysis of changes between the preoperative and postoperative orbital volumes at a 6-month follow-up. Results. Compared with the contralateral, nonaffected side, the orbital volume was 115.3 (±6.09)% preoperatively and 106.5 (±6.15)% postoperatively in the single approach group and 118.2 (±11.16)% preoperatively and 108.6 (±13.96)% postoperatively in the double approach. These results indicated that there was a significant difference between the preoperative and postoperative orbital volumes in each group (P < 0.05). However there was no significant difference between the single approach and the double approach (P > 0.05). Conclusions. Our results showed that there were no significant differences in surgical outcomes between the two modalities. The treatment modality may be selected based on the surgeons' preference, as well as the fracture type. PMID:25961049

  4. A peculiar blow-out fracture of the inferior orbital wall complicated by extensive subcutaneous emphysema: A case report and review of the literature

    PubMed Central

    Rzymska-Grala, Iwona; Palczewski, Piotr; Błaż, Marcin; Zmorzyński, Michał; Gołębiowski, Marek; Wanyura, Hubert

    2012-01-01

    Summary Background: Blow-out fracture of the orbit is a common injury. However, not many cases are associated with massive subcutaneous emphysema. Even fewer cases are caused by minor trauma or are associated with barotrauma to the orbit due to sneezing, coughing, or vomiting. The authors present a case of blow-out fracture complicated by extensive subcutaneous and mediastinal emphysema that occurred without any obvious traumatic event. Case Report: A 43-year-old man presented to the Emergency Department with a painful right-sided exophthalmos that he had noticed in the morning immediately after waking up. The patient also complained of diplopia. Physical examination revealed exophthalmos and crepitations suggestive of subcutaneous emphysema. The eye movements, especially upward gaze, were impaired. CT showed blow-out fracture of the inferior orbital wall with a herniation of the orbital soft tissues into the maxillary sinus. There was an extensive subcutaneous emphysema in the head and neck going down to the mediastinum. The patient did not remember any significant trauma to the head that could explain the above mentioned findings. At surgery, an inferior orbital wall fracture with a bony defect of 3×2 centimeter was found and repaired. Conclusions: Blow-out fractures of the orbit are usually a result of a direct trauma caused by an object with a diameter exceeding the bony margins of the orbit. In 50% of cases, they are complicated by orbital emphysema and in 4% of cases by herniation of orbital soft tissues into paranasal sinuses. The occurrence of orbital emphysema without trauma is unusual. In some cases it seems to be related to barotrauma due to a rapid increase in pressure in the upper airways during sneezing, coughing, or vomiting, which very rarely leads to orbital wall fracture. Computed tomography is the most accurate method in detecting and assessing the extent of orbital wall fractures. PMID:22844312

  5. Blowout fracture of the orbital floor secondary to vigorous nose blowing.

    PubMed

    Halpenny, D; Corbally, C; Torreggiani, W

    2012-01-01

    Orbital floor fracture due to vigorous nose blowing in the absence of mechanical trauma is rare, only four cases having previously been reported. In each of these cases, predisposing factors have been identified; preceding URTI in three and a history of sino-nasal surgery in the fourth case. We present the case of a 49-year-old woman who developed a maxillary sinus fracture and orbital emphysema after blowing her nose. PMID:23008887

  6. Endoscopic transnasal approach and intraoperative navigation for the treatment of isolated blowout fractures of the medial orbital wall.

    PubMed

    Copelli, C; Manfuso, A; d'Ecclesia, A; Catanzaro, S; Cassano, L; Pederneschi, N; Tewfik Hanna, K; Cocchi, R

    2015-12-01

    The aim of this study is to describe the reduction of medial orbital wall fractures using a combination of two different techniques: the endoscopic reduction and the navigation aided reconstruction. The endoscopic approach avoids an external incision and allows the observation of the fracture site clearly. Navigation-aided reconstruction is essential to achieve precise and predictable results in orbital reconstruction. It consists in an ideal virtual reconstruction of the target area created using a mirroring tool, and superimposing and comparing the unaffected and the affected sides. This technique opens a broad spectrum of possible surgical approaches, especially in situations in which anatomical landmarks for precise positioning of bone fragments, or bone grafts, are missing. This study is the first to combine these two techniques. The study was carried out in seven patients who underwent endoscopic reduction of isolated blowout fractures of the medial orbital wall and navigation-aided reconstruction at the authors' institution. This pilot study clearly shows that a combination of the endoscopic reduction and the navigation-aided reconstruction provides functional results and great advantages in terms of anatomical preservation and postoperative morbidity. PMID:26548529

  7. Transcaruncular Approach for Treatment of Medial Wall and Large Orbital Blowout Fractures.

    PubMed

    Nguyen, Dennis C; Shahzad, Farooq; Snyder-Warwick, Alison; Patel, Kamlesh B; Woo, Albert S

    2016-03-01

    We evaluate the safety and efficacy of the transcaruncular approach for reconstruction of medial orbital wall fractures and the combined transcaruncular-transconjunctival approach for reconstruction of large orbital defects involving the medial wall and floor. A retrospective review of the clinical and radiographic data of patients who underwent either a transcaruncular or a combined transcaruncular-transconjunctival approach by a single surgeon for orbital fractures between June 2007 and June 2013 was undertaken. Seven patients with isolated medial wall fractures underwent a transcaruncular approach, and nine patients with combined medial wall and floor fractures underwent a transcaruncular-transconjunctival approach with a lateral canthotomy. Reconstruction was performed using a porous polyethylene implant. All patients with isolated medial wall fractures presented with enophthalmos. In the combined medial wall and floor group, five out of eight patients had enophthalmos with two also demonstrating hypoglobus. The size of the medial wall defect on preoperative computed tomography (CT) scan ranged from 2.6 to 4.6 cm(2); the defect size of combined medial wall and floor fractures was 4.5 to 12.7 cm(2). Of the 11 patients in whom postoperative CT scans were obtained, all were noted to have acceptable placement of the implant. All patients had correction of enophthalmos and hypoglobus. One complication was noted, with a retrobulbar hematoma having developed 2 days postoperatively. The transcaruncular approach is a safe and effective method for reconstruction of medial orbital floor fractures. Even large fractures involving the orbital medial wall and floor can be adequately exposed and reconstructed with a combined transcaruncular-transconjunctival-lateral canthotomy approach. The level of evidence of this study is IV (case series with pre/posttest). PMID:26889348

  8. Endoscopic endonasal versus transfacial approach for blowout fractures of the medial orbital wall.

    PubMed

    Pagnoni, Mario; Giovannetti, Filippo; Amodeo, Giulia; Priore, Paolo; Iannetti, Giorgio

    2015-05-01

    In the last decades, the introduction of computed tomography has allowed an increase in the number of diagnosed fractures of the medial orbital wall. To repair medial wall fractures, many surgical techniques have been proposed (1), each one with its advantages and disadvantages. In this study, we compared endoscopic endonasal and transcutaneous reduction approaches in terms of surgery time and clinical outcome. Between 2001 and 2005, 81 patients with orbital wall fractures were treated at our department. Among these 81 patients, 24 (29.63%) were affected by a medial orbital fracture. Patients with fracture to both floor and medial walls underwent floor reduction by a transcutaneous subpalpebral approach (n = 9, 11.1%), whereas patients with isolated medial wall fracture underwent medial wall reduction by a transcutaneous subpalpebral approach using alloplastic implants (n = 8, 9.88%) or were treated by endoscopic approach (n = 5, 6.17%). After surgery, oculomotor function improved in all 22 patients. None of the patients had complications. Computed tomography revealed a well-consolidated site of fracture in both endoscopic endonasal and transcutaneous approaches. The average operating time for endoscopic endonasal and transfacial approach was 50 and 45 minutes, respectively. In this paper, the author proposed a results comparison between the endoscopic approach and the transcutaneous one. PMID:25974823

  9. Blowout fracture-orbital floor reconstruction using costochondral cartilage causing pain, warping, and diplopia

    PubMed Central

    Balaji, S. M.

    2015-01-01

    Orbital floor reconstruction is the most challenging component in the midfacial trauma management. Most often owing to the complexity of the fractures, the floor reconstruction requires grafts or other substitutes. Literature reveals several sources of autogenous sources of such grafts. Though most of the grafts are well taken and gives an ideal result, at certain instances, owing to the complex nature of the graft, its biochemical nature, reaction to the grafting, biochemical response, a reactionary change may result at late stages. The aim of this manuscript is to present a rare instance of warping of a costochondral graft that was used as a part of the orbital floor reconstruction giving rise to an ophthalmic emergency. The situation was immediately diagnosed and successfully managed. The situation, structural, and biochemical mechanisms behind such a phenomenon are discussed. PMID:26981485

  10. Blowout fracture-orbital floor reconstruction using costochondral cartilage causing pain, warping, and diplopia.

    PubMed

    Balaji, S M

    2015-01-01

    Orbital floor reconstruction is the most challenging component in the midfacial trauma management. Most often owing to the complexity of the fractures, the floor reconstruction requires grafts or other substitutes. Literature reveals several sources of autogenous sources of such grafts. Though most of the grafts are well taken and gives an ideal result, at certain instances, owing to the complex nature of the graft, its biochemical nature, reaction to the grafting, biochemical response, a reactionary change may result at late stages. The aim of this manuscript is to present a rare instance of warping of a costochondral graft that was used as a part of the orbital floor reconstruction giving rise to an ophthalmic emergency. The situation was immediately diagnosed and successfully managed. The situation, structural, and biochemical mechanisms behind such a phenomenon are discussed. PMID:26981485

  11. Formation fracturing kills Indonesian blowout

    SciTech Connect

    Wizyodiazjo, S.; Salech, M.; Sumanta, K.

    1982-11-15

    Dynamic killing methods without fracturing could not be applied in killing PT-29 blowout, due to the reservoir rock properties (shaley sand formation). A special fracturing and acidizing technique was required in order to allow the calculated kill rate of 40 bbl/ min. A low injection rate of 0.5 bbl/min with high injection pressure of 1,250 psi occurred due to a degree of formation damage and the mud cake covering the sand face. The calculated formation fracture pressure of 1,393 psi was a reliable value compared to actual fracture pressure of 1,400 psi. The designed killing rate of 40 bbl/ min could not reach the blowout well due to some leak-off of the injected fluid in unexpected directions of the induced fractures. Clearing PT-29 of all debris was very important for immediate well capping. The capping operation was done after the fire was extinguished; although the well was still flowing gas and water, no hazard of explosion was detected. The exact subsurface position of the blowout well of PT-29 was uncertain due to the lack of directional survey data. This problem reduced the effectiveness of the killing operation. A reliable water supply is important to the success of the killing job. Once the fracture had been induced, kill fluid had to be pumped continuously; any interruption might cause the fracture to heal. Deviation and directional survey data on every vertical or directional well are absolutely important for accurate relief well drilling purposes in case it is required.

  12. An analysis of pure blowout fractures and associated ocular symptoms.

    PubMed

    Shin, Jun Woo; Lim, Jin Soo; Yoo, Gyeol; Byeon, Jun Hee

    2013-05-01

    Blowout fractures are one of the commonly occurring facial bone fractures and clinically important, as they may cause serious complications such as diplopia, extraocular movement limitation, and enophthalmos. The purpose of this study was to evaluate the current patient demographics and surgical outcomes of 952 pure blowout fractures from 2 hospitals of the Catholic University of Korea, from 2003 to 2011. The medical records were reviewed according to the cause, fracture site, ocular symptoms, time of operation, and sequela. Male patients outnumbered female patients, and blowout fractures were most often seen in 21- to 30-year-old men. The most common cause was violent assault (40.7%). The medial orbital wall (45.8%) was the most common site, followed by floor (29.4%) and inferomedial wall (24.6%). The most common ocular injury was hyphema. Diplopia was presented in 27.6%; extraocular movement limitation was detected in 12.8% patients, and enophthalmos was encountered in 3.4% patients. Diplopia, extraocular movement limitation, and enophthalmos were significantly improved by surgical repair (P < 0.05). Postoperative complications were persistent diplopia (1.6%) and enophthalmos (0.4%). We surveyed a large series of blowout fracture in the Republic of Korea and recommend this study to serve as an important guideline in treating pure blowout fractures. PMID:23714863

  13. Blowout Fracture in a 3-Year-Old

    PubMed Central

    Pluijmers, Britt I.; Koudstaal, Maarten J.; Paridaens, Dion; van der Wal, Karel G.H.

    2013-01-01

    A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed. PMID:24436749

  14. Blowout fracture in a 3-year-old.

    PubMed

    Pluijmers, Britt I; Koudstaal, Maarten J; Paridaens, Dion; van der Wal, Karel G H

    2013-06-01

    A 3-year-old patient was referred to the oral and maxillofacial department with a fracture of the orbital floor. Due to the lack of clinical symptoms, a conservative approach was chosen. After 3 weeks, an enophthalmos developed. The orbital floor reconstruction was successfully performed through a transconjunctival approach. This case highlights the rarity of pure blowout fractures in young children. The specific presentation and diagnostics of orbital floor fractures in children and the related surgical planning and intervention are discussed. PMID:24436749

  15. Isolated trapdoor-type medial blowout fracture in an adult presenting horizontal diplopia treated by endoscopic endonasal approach.

    PubMed

    Noh, Woong Jae; Park, Tae Jung; Kim, Joo Yeon; Kwon, Jae Hwan

    2013-01-01

    Orbital blowout fracture frequently occurs along the floor or medial aspect of the orbital wall, which are the two thinnest areas of the bony orbit. True trapdoor injury of the orbit is less common and is rare as an isolated medial wall injury, because the medial orbital wall has several bony septa within the ethmoid sinus that provide support and decrease the risk of a trapdoor fracture. Additionally, the incidence of trapdoor-type blowout fracture in adults is lower than in children. In a trapdoor-type blowout fracture with restricted ocular movement, prompt diagnosis and early intervention are associated with better clinical outcomes. We encountered a case of trap door-type medial blowout fracture with horizontal eye ball movement limitation in an adult. She underwent endonasal endoscopic reduction surgery for the medial blowout fractures. Here we report this case, and suggest early diagnosis and prompt surgical exploration. PMID:24964421

  16. Blowout Fracture after Descemet's Stripping Automated Endothelial Keratoplasty

    PubMed Central

    Tachibana, Eri; Koh, Shizuka; Maeda, Naoyuki; Nishida, Kohji

    2014-01-01

    We present the case of an 86-year-old woman who developed a blowout fracture after Descemet's stripping automated endothelial keratoplasty (DSAEK). Sixteen months after DSAEK, she suffered a blow to her left eye caused by a fall. Computed tomography confirmed the presence of a blowout fracture of the inferior wall of the left orbit with soft tissue prolapsing into the orbit. The patient complained of no abnormal symptoms, and her operated cornea was intact and clear. There was no abnormal finding in both the anterior and posterior segments. This case highlights that the DSAEK technique provides adequate tectonic stability of the globe throughout the traumatic event in contrast to penetrating keratoplasty, which can lead to devastating vision damage after trauma. PMID:25759661

  17. Blowout Fracture after Descemet's Stripping Automated Endothelial Keratoplasty.

    PubMed

    Tachibana, Eri; Koh, Shizuka; Maeda, Naoyuki; Nishida, Kohji

    2014-01-01

    We present the case of an 86-year-old woman who developed a blowout fracture after Descemet's stripping automated endothelial keratoplasty (DSAEK). Sixteen months after DSAEK, she suffered a blow to her left eye caused by a fall. Computed tomography confirmed the presence of a blowout fracture of the inferior wall of the left orbit with soft tissue prolapsing into the orbit. The patient complained of no abnormal symptoms, and her operated cornea was intact and clear. There was no abnormal finding in both the anterior and posterior segments. This case highlights that the DSAEK technique provides adequate tectonic stability of the globe throughout the traumatic event in contrast to penetrating keratoplasty, which can lead to devastating vision damage after trauma. PMID:25759661

  18. Blow-Out Fracture due to a Hazel Stick Beat.

    PubMed

    Erbilen, Esin; Yuksel, Harun; Onder, H Ibrahim; Tunc, Murat; Kaya, Murat

    2008-12-01

    The aim of this case report is to demonstrate that blow-out fractures can occur not only by a classical trauma mechanism but also from the consequences of a stick beat. A 66-year-old male was admitted to our hospital complaining of a sudden swelling of his right eyelid after blowing his nose. In his medical history there was the report of a hazel stick beat the previous day. Upon ophthalmological examination, ecchymosis was observed in the right orbital region, and subcutaneous amphisema in addition to a dense subconjunctival hemorrhage were detected. Using computed tomography (CT), the intraorbital air density in the soft tissues and the right maxillary sinus wall fracture possessing fluid density compatible with hemorrhage was observed. The patient was treated conservatively with prednisolone and antibiotics. We conclude that a blow-out fracture may occur in patients who experience orbital trauma, even in cases of low-energy trauma. These patients may be symptomatic after an episode of hard nose-blowing. PMID:25610052

  19. White-eyed blowout fracture: Diagnostic pitfalls and review of literature.

    PubMed

    Yew, Ching Ching; Shaari, Ramizu; Rahman, Shaifulizan Abdul; Alam, Mohammad Khursheed

    2015-09-01

    White-eyed blowout fracture was first termed by Jordan et al. in individuals sustaining a blow to the periocular area and presenting with ocular symptoms, although with minimal soft tissue signs of trauma. It is often found in pure orbital floor blowout fractures among paediatric patients, and it could manifest as a linear or hinge-like trapdoor deformity. Unlike the more common open orbital blowout fractures with distinct diagnostic clinical signs, white-eyed blowout fractures are rarer and their diagnoses can be easily missed, subsequently costing an optimal time window for surgical intervention. This is critical as better outcomes are found with earlier release of entrapments. This report describes a case of a white-eyed blowout fracture in a 10-year-old child faced with its diagnostic challenges. The current literature review discusses the types of fracture pattern, signs and symptoms, mechanism of action, as well as timing of surgery. In view of the common complication of persistent diplopia, clinical pitfalls in achieving this diagnosis are emphasized to prevent any delay of treatment. Current literature evidences are weighted towards urgent surgical intervention, as positive outcomes are found to correlate with earlier release of entrapments. PMID:25986667

  20. Diplopia and enophthalmos in blowout fractures.

    PubMed

    Hwang, Kun; Huan, Fan; Hwang, Pil Joong

    2012-07-01

    The aim of this study was to compare the changes of diplopia and enophthalmos in patients with blowout fractures. Three hundred sixty-two patients who presented with blowout fractures between March 2006 and February 2011 were analyzed. The sequential time changes of diplopia and enophthalmos were measured in the operated group and the observed group according to (1) the duration of preoperative observation (early: within 7 days, late: 8-14 days, delayed: >15 days); (2) the defect size (minimal: <1 cm(2), small: 1.1-2.0 cm, medium: 2.1-3.0 cm(2), large: >3.0 cm(2)); and (3) the age of the patients (<20, 21-40, 41-60, >61 years).Among the 362 patients, 242 (66.9%) had an operation, and 120 (33.1%) did not. The duration of preoperative observation did not affect the postoperative diplopia or enophthalmos. There were significant differences of enophthalmos among the operated groups with a different defect size at the preoperative period (P = 0.036 [Pearson χ(2)]). There were significant differences of diplopia among the operated groups with different defect sizes at the 6 months' follow-up period (P = 0.014 [Pearson χ(2)]). The diplopia in the older age group (>60 years) was significantly greater than that of the other 3 groups at 6 months (P = 0.023) and at 12 months (P = 0.023, [Pearson χ(2)]).We think surgery should be delayed until the swelling is decreased unless the medial rectus muscle is incarcerated. We also think that the defect size is not an important factor for whether to perform surgery. We think that the reason for the greater diplopia in the older age group is that the adaptation of binocular convergence is decreased in the older age group. PMID:22777445

  1. Blowouts

    NASA Technical Reports Server (NTRS)

    2006-01-01

    [figure removed for brevity, see original site] Context image for PIA03699 Blowouts

    The dark crescents in this image are the backside of wind blowout features. Blowouts are common on Earth in beach regions and in the American MidWest.

    Image information: VIS instrument. Latitude 1.1N, Longitude 202.8E. 18 NASA/JPL/ASUmeter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  2. Nontraumatic orbital floor fracture after nose blowing.

    PubMed

    Sandhu, Ranjit S; Shah, Akash D

    2016-03-01

    A 40-year-old woman with no history of trauma or prior surgery presented to the emergency department with headache and left eye pain after nose blowing. Noncontrast maxillofacial computed tomography examination revealed an orbital floor fracture that ultimately required surgical repair. There are nontraumatic causes of orbital blowout fractures, and imaging should be obtained irrespective of trauma history. PMID:26973725

  3. Nontraumatic orbital floor fracture after nose blowing

    PubMed Central

    Sandhu, Ranjit S.; Shah, Akash D.

    2016-01-01

    A 40-year-old woman with no history of trauma or prior surgery presented to the emergency department with headache and left eye pain after nose blowing. Noncontrast maxillofacial computed tomography examination revealed an orbital floor fracture that ultimately required surgical repair. There are nontraumatic causes of orbital blowout fractures, and imaging should be obtained irrespective of trauma history. PMID:26973725

  4. Transient ipsilateral mydriasis during correction of left blowout fracture.

    PubMed

    Lee, Ju-Min; Kim, Cheul-Hong; Kim, Uk-Kyu; Chung, In-Kyo

    2014-03-01

    Mydriasis, either bilateral or unilateral, seldom occurs during reconstruction of periorbital fracture. Anisocoria, a unilateral mydriasis, requires more urgent assessment than bilateral mydriasis does. Pharmacologic agents, local anesthetic infiltration, as well as direct or indirect oculomotor nerve damage are possible causes of unilateral mydriasis. Few cases have been reported about intraoperative temporary ipsilateral mydriasis during correction of blowout fracture. We have experienced an unusual case of anisocoria and report the case with literature reviews. PMID:24561370

  5. The white-eyed blowout fracture in the child: beware of distractions.

    PubMed

    Hammond, D; Grew, N; Khan, Z

    2013-01-01

    Inferior 'trapdoor' orbital floor fractures with muscle and soft tissue incarceration are the most common type of orbital fracture in children. Delays to treatment can lead to a significant morbidity. It has been recommended that children who present with a 'white-eyed blowout' fracture should have surgery performed within 48h of diagnosis, otherwise prognosis is poor. A 14-year-old boy was initially misdiagnosed with a head injury due to the minor appearance of his orbital injury and his presenting complaint of nausea and vomiting. This resulted in a significant delay to surgery. The oculovagal reflex associated with orbital injuries is well documented (Wei and Durairaj in Pediatric orbital floor fractures. J AAPOS 2011;15: :173-80). It should be considered by emergency department and paediatric staff when dealing with patients who have sustained a blow to the orbital region, despite not having a subconjunctival haemorrhage. The importance of examination to detect other features of orbital blow-out and entrapment are stressed. PMID:24964459

  6. The Frequency of Decreased Visual Acuity in Orbital Fractures.

    PubMed

    Kim, Yeon Soo; Kim, Joo Ho; Hwang, Kun

    2015-07-01

    The aim of this systematic review is to summarize and evaluate the effect of orbital fractures (blowout fractures and nonblowout fractures) on visual acuity. In PubMed search and Scopus search, the terms "orbital fracture OR maxillofacial injury OR facial trauma OR craniofacial fracture," and "visual acuity OR functional outcome OR visual outcome OR improving document of visual acuity OR blindness OR optic nerve neuropathy" were used, which resulted in 1634 and 1152 papers, respectively. Of the 2226 titles excluding 560 duplicated titles, 227 abstracts were reviewed. Of the 227 abstracts reviewed, the authors found 56 potentially relevant full-text articles, of which 5 studies met our inclusion criteria. The odds ratio and 95% confidence intervals from each study were abstracted. The statistical analysis was performed with review manager (The Nordic Cochrane Centre). A summary of 5 studies affirmed that 43 patients among 532 orbital fractures (8.1%) had decreased visual acuity. Twelve patients among 159 blowout fractures (7.5%) had decreased visual acuity. Thirty-one patients among 373 orbital fractures other than pure blowout fractures (8.3%) had decreased visual acuity. In orbital fractures other than pure blowout fractures, the frequency of decreased visual acuity was higher than pure blowout fractures (n = 532, odds ratio, 2.23, 95% confidence interval = 1.06-4.70). Surgeons should acknowledge this with patients before surgery. PMID:26114513

  7. Isolated bilateral blowout fracture with extensive pneumatization of the maxillary sinuses.

    PubMed

    Corrrêa, Ana Paula Simões; Boss, Fernanda Brasil Daura Jorge; Coléte, Juliana Zorzzi; Porzoni, Daniela; Bassi, Ana Paula Farnezi; Aranega, Alessandra Marcondes; Ávila Souza, Francisley; Garcia-Júnior, Idelmo Rangel

    2014-07-01

    The blowout fracture injuries are often associated with fractures of the zygomatic complex and other facial structures but can also occur in an isolated fashion. Isolated bilateral blowout fractures are uncommon and constitute a challenge with regard to both assessment and reconstruction. This article describes an uncommon case of isolated bilateral blowout fracture in a patient with extensive pneumatization of the maxillary sinuses. PMID:24902117

  8. Timing of operation for blowout fractures with extraocular muscle entrapment.

    PubMed

    Sugamata, Akira; Yoshizawa, Naoki; Shimanaka, Kosuke

    2013-12-01

    Many authors have advocated early surgical intervention to avoid muscle degeneration in patients with blowout fractures with evidence of extraocular muscle entrapment imaged under computed tomography. However, there is still no golden standard with regard to the target timing of operations for releasing extraocular muscle. Between January 2002 and December 2011, the authors treated eight cases of blowout fracture with extraocular muscle entrapment. Notes from presumed cases of blowout fracture were retrospectively reviewed for information relating to surgical treatment and prognosis. In this series, a patient who was operated on 7 hours after injury showed the quickest recovery from diplopia. In contrast, a patient who was operated on 18 days after injury showed persistent diplopia for 2 years. Nevertheless, in patients who were operated on 3-11 days after injury, there was no obvious correlation between the outcome and the number of days between injury and the operation. It is concluded that, when emergency surgical intervention within several hours is not possible, it should be performed as soon after the injury as possible in order to prevent the increase of predictive fibrosis around the extraocular muscle. PMID:23848420

  9. Alloplastic template fixation of blow-out fracture.

    PubMed

    Hwang, Kun; Kita, Yoko

    2002-07-01

    Alloplasts are widely used to reconstruct the orbital defects. The alloplastic material, however, is not uncommonly infected, displaced, and extruded, and forms an epithelial pseudocyst around it. To prevent the depressed fractured bone of the orbital floor from dropping down into the maxillary sinus, an en block fragment of the depressed fracture of the orbital floor was restored after being attached to an alloplastic sheet template which was fixed to the intact orbital floor. This procedure is simple and secure, and intramaxillary packing is not needed to buttress the depressed fractured bone into the sinus. PMID:12140413

  10. A clinical analysis of bilateral orbital fracture.

    PubMed

    Roh, Joon Ho; Jung, Jee Woong; Chi, Mijung

    2014-03-01

    Although bilateral orbital fracture can cause serious eyeball and facial skeletal problems, few reports have been issued on the topic. We analyzed the clinical features of bilateral orbital fracture by reviewing the medical records of 147 patients and compared bilateral and unilateral fractures by reviewing the literature.Bilateral orbital fracture was most common in men aged between 50 and 59 years. A traffic accident was the leading cause of trauma, and average time between trauma and surgery was 12.2 days. Bilateral medial fracture accompanied by nasal fracture accounted for the overwhelming majority, and impure blowout fracture in at least 1 eye occurred in 69.4% of the 147 patients. Associated ocular injuries seemed to be similar for bilateral and unilateral fracture. Thirty-five patients (23.8%) had other multiple traumas affecting other than the eyes, and this significantly increased the need for surgery (P < 0.05). Of the 48 patients who underwent surgery, including 4 cases of bilateral surgery, 21 patients who had ocular motility restriction with central diplopia within 30 degrees almost completely recovered. No significant relation between the timing of surgery and improvement was found. Although unilateral surgery was performed in most cases, facial asymmetry related to enophthalmos was unclear at 6 months postoperatively.In summary, bilateral orbital fracture was found to be clinically distinguishable from unilateral fracture in several aspects. We hope these findings provide a reference guide to the approach and management of bilateral orbital fracture. PMID:24514894

  11. 'White-eyed' blowout fracture: a case series of five children.

    PubMed

    Foulds, J S; Laverick, S; MacEwen, C J

    2013-06-01

    The 'white-eyed' blowout fracture is an orbital injury in children that is commonly initially misdiagnosed as a head injury because of predominant autonomic features and lack of soft-tissue signs. We present five patients who presented with nausea and vomiting following an apparent mild head or facial injury. None of the five had any external evidence of injury. Despite each case describing diplopia, there was a delayed diagnosis of at least 24 h. CT examination demonstrated an inferior orbital wall fracture in all cases with entrapment of the inferior rectus muscle. Each patient underwent surgical repair, two within 48 h of their injury, both of whom achieved complete recovery of ocular movements, while three were delayed beyond 48 h, with a resulting residual limitation of upgaze in all. It is, therefore, important for clinicians to be aware of this condition, so that it can be diagnosed early in order for early surgical release to be performed, which is associated with an excellent prognosis. PMID:23592727

  12. Three Cases of Acquired Simulated Brown Syndrome after Blowout Fracture Operations

    PubMed Central

    Ji, So Young; Yoo, Jae Hong; Ha, Won; Lee, Ji Won

    2015-01-01

    Brown syndrome is known as limited elevation of the affected eye during adduction. It is caused by a disorder of the superior oblique tendon, which makes it difficult for the eyeball to look upward, especially during adduction. It is classified into congenital true sheath Brown syndrome and acquired simulated Brown syndrome. Acquired simulated Brown syndrome can be caused by trauma, infection, or inflammatory conditions. The surgical restoration of blowout fractures can also lead to limitations of ocular motility, including Brown syndrome. We report on three patients with acquired simulated Brown syndrome, who complained of diplopia and limitation of ocular motility after operations to treat blowout fractures. PMID:26015892

  13. Three cases of acquired simulated brown syndrome after blowout fracture operations.

    PubMed

    Ji, So Young; Yoo, Jae Hong; Ha, Won; Lee, Ji Won; Yang, Wan Suk

    2015-05-01

    Brown syndrome is known as limited elevation of the affected eye during adduction. It is caused by a disorder of the superior oblique tendon, which makes it difficult for the eyeball to look upward, especially during adduction. It is classified into congenital true sheath Brown syndrome and acquired simulated Brown syndrome. Acquired simulated Brown syndrome can be caused by trauma, infection, or inflammatory conditions. The surgical restoration of blowout fractures can also lead to limitations of ocular motility, including Brown syndrome. We report on three patients with acquired simulated Brown syndrome, who complained of diplopia and limitation of ocular motility after operations to treat blowout fractures. PMID:26015892

  14. Comparison of Absorbable Mesh Plate versus Titanium-Dynamic Mesh Plate in Reconstruction of Blow-Out Fracture: An Analysis of Long-Term Outcomes

    PubMed Central

    Baek, Woon Il; Kim, Woo Seob; Bae, Tae Hui

    2014-01-01

    Background A blow-out fracture is one of the most common facial injuries in midface trauma. Orbital wall reconstruction is extremely important because it can cause various functional and aesthetic sequelae. Although many materials are available, there are no uniformly accepted guidelines regarding material selection for orbital wall reconstruction. Methods From January 2007 to August 2012, a total of 78 patients with blow-out fractures were analyzed. 36 patients received absorbable mesh plates, and 42 patients received titanium-dynamic mesh plates. Both groups were retrospectively evaluated for therapeutic efficacy and safety according to the incidence of three different complications: enophthalmos, extraocular movement impairment, and diplopia. Results For all groups (inferior wall fracture group, medial wall fractrue group, and combined inferomedial wall fracture group), there were improvements in the incidence of each complication regardless of implant types. Moreover, a significant improvement of enophthalmos occurred for both types of implants in group 1 (inferior wall fracture group). However, we found no statistically significant differences of efficacy or complication rate in every groups between both implant types. Conclusions Both types of implants showed good results without significant differences in long-term follow up, even though we expected the higher recurrent enophthalmos rate in patients with absorbable plate. In conclusion, both types seem to be equally effective and safe for orbital wall reconstruction. In particular, both implant types significantly improve the incidence of enophthalmos in cases of inferior orbital wall fractures. PMID:25075357

  15. Orbital fractures in children: a review of outcomes.

    PubMed

    Gerber, Barbara; Kiwanuka, Paul; Dhariwal, Daljit

    2013-12-01

    The third most common facial fractures in children are fractures of the orbit, and the medial wall and floor are the commonest sites affected. The aetiology, clinical presentation, and timing of operation all differ from those of adults. If there are few or no clinical signs, but oculocardiac reflex is present, it is highly suggestive of trapdoor injury. This retrospective study includes all consecutive children (younger than 18 years) referred with confirmed fractures of the orbital floor over a 5-year period (2005-2010). A total of 24 patients were identified with a mean age of 13.5 years, and most injuries were secondary to falls. Isolated injury to the orbital floor occurred in 14 (58%); the rest involved other fractures of the orbital wall or face, or both. There were 11 trapdoor fractures (46%), and 9 open blow-out fractures (38%). Overall, nausea and vomiting occurred in 13 patients (54%); 8 of these had trapdoor fractures. Most patients had operations (22, 92%), and the mean time to operation was 4 days. Complications increased with delays to theatre. Those operated on within 1 day had fewer complications than those who had operations after 3 days. Postoperatively, diplopia (n=6/11) and restricted eye movement (n=3/11) were associated with trapdoor injury, while enophthalmos (n=1/9) and paraesthesia (n=3/9) were related to open blow-out fractures. To reduce compromised outcomes, prompt operation is warranted in all children with fractures of the orbital floor regardless of the configuration. PMID:23915493

  16. Precaruncular approach for the reconstruction of medial orbital wall fractures.

    PubMed

    You, Hi-Jin; Kim, Deok-Woo; Dhong, Eun-Sang; Yoon, Eul-Sik

    2014-01-01

    To reconstruct medial orbital wall fractures with a clear, least dissection, an alternative method, precaruncular approach, has been performed. We reviewed 36 patients with medial blowout fractures treated with this technique. The incision was made between the caruncle and medial canthal skin at the mucocutaneous junction, and was continued along the conjunctival fornix superiorly and inferiorly. An extended conjunctival incision was carried for additional access to the orbit floor. The dissection continued medially and proceeded along the preseptal plane. The clinical results were assessed by postoperative computed tomographic scan and by reviewing postoperative complications. Postoperatively, computed tomographic scans demonstrated adequate reduction of soft tissues and correct positioning of the inserted implant without surgical complications. In most cases, the edema resolved within 24 to 48 hours after surgery. The precaruncular approach is a good option in reconstructing medial orbital wall fractures because it provides satisfactory exposure with superior cosmetic result. PMID:23241800

  17. Mechanisms of orbital floor fractures: a clinical, experimental, and theoretical study.

    PubMed Central

    Bullock, J D; Warwar, R E; Ballal, D R; Ballal, R D

    1999-01-01

    PURPOSE: The purpose of this study was to investigate the two accepted mechanisms of the orbital blow-out fracture (the hydraulic and the buckling theories) from a clinical, experimental, and theoretical standpoint. METHODS: Clinical cases in which blow-out fractures resulted from both a pure hydraulic mechanism and a pure buckling mechanism are presented. Twenty-one intact orbital floors were obtained from human cadavers. A metal rod was dropped, experimentally, onto each specimen until a fracture was produced, and the energy required in each instance was calculated. A biomathematical model of the human bony orbit, depicted as a thin-walled truncated conical shell, was devised. Two previously published (by the National Aeronautics Space Administration) theoretical structural engineering formulas for the fracture of thin-walled truncated conical shells were used to predict the energy required to fracture the bone of the orbital floor via the hydraulic and buckling mechanisms. RESULTS: Experimentally, the mean energy required to fracture the bone of the human cadaver orbital floor directly was 78 millijoules (mj) (range, 29-127 mj). Using the engineering formula for the hydraulic theory, the predicted theoretical energy is 71 mj (range, 38-120 mj); for the buckling theory, the predicted theoretical energy is 68 mj (range, 40-106 mj). CONCLUSION: Through this study, we have experimentally determined the amount of energy required to fracture the bone of the human orbital floor directly and have provided support for each mechanism of the orbital blow-out fracture from a clinical and theoretical basis. Images FIGURE 2 FIGURE 3 FIGURE 4 FIGURE 5A FIGURE 5B FIGURE 5E FIGURE 5F PMID:10703119

  18. Factors Associated with Significant Ocular Injury in Conservatively Treated Orbital Fractures

    PubMed Central

    Layton, Christopher J.

    2014-01-01

    Purpose. To determine factors associated with the presence of significant ocular injury in subjects with orbital fractures. Subjects. A consecutive prospective cohort of 161 patients presenting to a general tertiary referral hospital with orbital fractures and undergoing initial conservative treatment was identified. Subjects were assessed at time of injury for the need for emergency surgery, and those initially treated conservatively were subsequently followed up by the Ophthalmology Department to assess for ocular injury requiring ophthalmic management at 1–7 days after injury. Associations between ocular injury and age, sex, visual acuity, presence of blowout fracture, extent of orbital involvement, and presence of distant facial fractures were assessed. Results. 142 male (average age of 32 [95% CI 30–35]) and 19 female (average age of 49 [95% CI 39–59]) subjects were identified. 17 subjects were diagnosed with significant ocular injury. Ocular injury was significantly associated with LogMAR VA worse than 0.2 (OR 49 [95% CI 11–217, P < 0.0001]), but no relationship was noted for age, sex, presence of blowout fracture, extent of fractures, or presence of distal facial fractures. LogMAR visual acuity worse than or equal to 0.2 had a 98% negative predictive value for ocular injury in the setting of orbital fractures. Conclusions. Demographic and nonophthalmic fracture characteristics were not useful predictors of ocular injury in orbital fractures. LogMAR visual acuity worse than or equal to 0.2 is a highly sensitive and useful guide of the need for ophthalmic referral in subjects with orbital fractures. PMID:25580279

  19. Factors associated with significant ocular injury in conservatively treated orbital fractures.

    PubMed

    Layton, Christopher J

    2014-01-01

    Purpose. To determine factors associated with the presence of significant ocular injury in subjects with orbital fractures. Subjects. A consecutive prospective cohort of 161 patients presenting to a general tertiary referral hospital with orbital fractures and undergoing initial conservative treatment was identified. Subjects were assessed at time of injury for the need for emergency surgery, and those initially treated conservatively were subsequently followed up by the Ophthalmology Department to assess for ocular injury requiring ophthalmic management at 1-7 days after injury. Associations between ocular injury and age, sex, visual acuity, presence of blowout fracture, extent of orbital involvement, and presence of distant facial fractures were assessed. Results. 142 male (average age of 32 [95% CI 30-35]) and 19 female (average age of 49 [95% CI 39-59]) subjects were identified. 17 subjects were diagnosed with significant ocular injury. Ocular injury was significantly associated with LogMAR VA worse than 0.2 (OR 49 [95% CI 11-217, P < 0.0001]), but no relationship was noted for age, sex, presence of blowout fracture, extent of fractures, or presence of distal facial fractures. LogMAR visual acuity worse than or equal to 0.2 had a 98% negative predictive value for ocular injury in the setting of orbital fractures. Conclusions. Demographic and nonophthalmic fracture characteristics were not useful predictors of ocular injury in orbital fractures. LogMAR visual acuity worse than or equal to 0.2 is a highly sensitive and useful guide of the need for ophthalmic referral in subjects with orbital fractures. PMID:25580279

  20. Biomaterials for orbital fractures repair

    PubMed Central

    Totir, M; Ciuluvica, R; Dinu, I; Careba, I; Gradinaru, S

    2014-01-01

    The unique and complex anatomy of the orbit requires significant contouring of the implants to restore the proper anatomy. Fractures of the orbital region have an incidence of 10-25% from total facial fractures and the most common age group was the third decade of life. The majority of cases require reconstruction of the orbital floor to support the globe position and restore the shape of the orbit. The reason for this is that the bony walls are comminuted and/or bone fragments are missing. Therefore, the reconstruction of missing bone is important rather than reducing bone fragments. This can be accomplished using various materials. There is hardly any anatomic region in the human body that is so controversial in terms of appropriate material used for fracture repair: nonresorbable versus resorbable, autogenous/allogenous/xenogenous versus alloplastic material, non-prebent versus preformed (anatomical) plates, standard versus custom-made plates, nonporous versus porous material, non-coated versus coated plates. Thus, the importance of material used for reconstruction becomes more challenging for the ophthalmologist and the oral and maxillofacial surgeon. PMID:27057250

  1. Biomaterials for orbital fractures repair

    PubMed Central

    Totir, M; Ciuluvica, R; Dinu, I; Careba, I; Gradinaru, S

    2015-01-01

    The unique and complex anatomy of the orbit requires significant contouring of the implants to restore the proper anatomy. Fractures of the orbital region have an incidence of 10-25% from the total facial fractures and the most common age group was the third decade of life. The majority of cases required reconstruction of the orbital floor to support the globe position and restore the shape of the orbit. The reason for this was that the bony walls were comminuted and/ or bone fragments were missing. Therefore, the reconstruction of the missing bone was important rather than reducing the bone fragments. This could be accomplished by using various materials. There is hardly any anatomic region in the human body that is so controversial in terms of appropriate material used for fracture repair: non resorbable versus resorbable, autogenous/ allogeneic/ xenogenous versus alloplastic material, non-prebent versus preformed (anatomical) plates, standard versus custom-made plates, nonporous versus porous material, non-coated versus coated plates. Thus, the importance of the material used for reconstruction becomes more challenging for the ophthalmologist and the oral and maxillofacial surgeon. PMID:25914737

  2. Emergency decompression of tension retrobulbar emphysema secondary to orbital floor fracture.

    PubMed

    Tomasetti, Patrick; Jacbosen, Christine; Gander, Thomas; Zemann, Wolfgang

    2013-01-01

    Orbital floor fractures are generally the result of blowout orbital and may be associated with orbital emphysema leading to proptosis and even to loss of vision. A 49-year-old woman fractured the orbital floor in a fall. After blowing her nose, she developed exophthalmos and severe reduction in vision. She consulted our department and underwent emergency surgical management with orbital drainage. Decompression led to immediate resolution of the exophthalmos and postoperative improvement in visual acuity. Urgent decompression is indicated by the presence of proptosis, elevated intraocular pressure, and progressive loss of vision in cases of orbital trauma with additional emphysema. Surgical treatment of tension emphysema includes lateral canthotomy or cantholysis, needle aspiration, transconjunctival, or lateral blepharoplasty approach, and bone decompression depending on the severity of the case. Sneezing or blowing the nose can lead to proptosis and decreased visual acuity secondary to trauma to the orbit. Under such circumstances, emergency decompression is essential. PMID:24964422

  3. Traumatic carotid-cavernous sinus fistula accompanying abducens nerve (VI) palsy in blowout fractures: missed diagnosis of 'white-eyed shunt'.

    PubMed

    Kim, Jin-Woo; Kim, Sun-Jong; Kim, Myung-Rae

    2013-04-01

    We report the case of a 32-year-old woman with bilateral blowout fractures. She presented with diplopia showing impaired abduction of the left eye soon after trauma. No other orbito-ocular signs, such as exophthalmos, ptosis, or chemosis, were found. Orbital reconstruction was performed, but no improvement in her ophthalmoplegia was observed after surgery. A carotid angiography showed that she was suffering from a posteriorly draining carotid-cavernous sinus fistula with isolated abducens nerve palsy. Coil embolization was conducted under the consultation of a neurosurgeon, after which her ophthalmoplegia resolved fully. This is a rare case of posteriorly draining carotid-cavernous sinus fistula without classic orbito-ocular signs, the absence of which may cause diagnostic confusion. PMID:23415244

  4. The functional outcome of blow-out fractures managed surgically and conservatively: our experience in 100 patients.

    PubMed

    Felding, Ulrik Ascanius; Rasmussen, Janne; Toft, Peter Bjerre; von Buchwald, Christian

    2016-07-01

    The proportion of orbital blow-out fractures (BOFs) which are operated upon varies. The purpose of this study was to determine the treatment pattern of BOFs at our tertiary trauma centre and to evaluate the functional outcomes in patients according to whether they were managed surgically or conservatively. The study design is a retrospective cohort study and the setting is Tertiary care University Hospital. The participants include patients with isolated BOFs admitted to our Trauma Unit from 2010 to 2013. Of the 100 consecutive patients included, 60 had available follow-up data. The presence of diplopia and enophthalmus was determined by reviewing the medical records. Data from the patients' initial consultation and their 3-month follow-up were also collected. Of the 60 patients whose data could be analysed, 36 had been managed surgically and 24 conservatively. Of the patients managed surgically, 25 had diplopia in peripheral gaze before surgery and 12 at 3-month follow-up. Nine had diplopia in primary gaze before surgery and none at 3-month follow-up. Five had enophthalmus before surgery and two at 3-month follow-up. Of the patients managed conservatively, eight had diplopia in peripheral gaze initially and seven at 3-month follow-up. Three had diplopia in primary gaze initially and one at 3-month follow-up. One had enophthalmus initially which was still present at 3-month follow-up. Primary gaze diplopia disappeared while secondary gaze diplopia was present in about a third of patients, whether managed surgically or conservatively at the 3-month follow-up. Standardised follow-up as well as clear indications for and against surgery are warranted. PMID:26935055

  5. Orbital fractures: a new classification and staging of 190 patients.

    PubMed

    Carinci, Francesco; Zollino, Ilaria; Brunelli, Giorgio; Cenzi, Roberto

    2006-11-01

    The orbit is located in the middle third of the face, composed of several bones and surrounded by complex anatomic structures so that orbital fractures (OF) often involve other parts of the face. A staging system for classifying OF is of paramount importance in order to exchange information between trauma centers. Several classifications have been proposed for describing OF but they have not a single method applicable to the whole orbit. Here, a classification for OF that can be summarized with four abbreviations is proposed. Four letters define the localization (F = frontal, N = nasal, M = maxillary and Z = zygomatic bone fracture), two acronyms describe fragment shift (in = blow-in or out = blow-out), four numbers define ocular movement impairment (1 = superior, 2 = internal, 3 = inferior, and 4 = external extrinsic muscular deficit) and two acronyms describe eye position (EX = exophthalmos and ENO = enophthalmos). To evaluate the suitability of the proposed classification a retrospective study on a series of 190 OFs is performed. Age, gender, new stage, clinical diagnosis at admission, type of surgery, and need for graft for orbital reconstruction are considered. A good correlation between the proposed classification and the studied variables is detected. In conclusion, the proposed classification is a simply and precise method to stage OF. It can summarize OF and be used in the daily practice. However, it is our belief that a multi-center study should be performed before the effectiveness of the proposed classification can be clearly stated. PMID:17119402

  6. The isolated orbital floor fracture from a transconjunctival or subciliary perspective-A standardized anthropometric evaluation

    PubMed Central

    Djedovic, Gabriel; Peisker, Andre; Wohlrath, Rene; Rieger, Ulrich; Guentsch, Arndt; Gomez-Dammeier, Marta; Schultze-Mosgau, Stefan

    2016-01-01

    Background The influence of orbital fractures and their repair on the rate of deformities of the lower eyelid is an ongoing source of discussion in the literature. Most of the present studies include isolated blowout as well as combined orbital fractures. Material and Methods We present a retrospective evaluation of a series of 100 patients after isolated blowout fracture repair using reference anthropometric data on standardized photographs. Analysis included eye fissure width and height, lid sulcus height, upper lid height, upper and lower iris coverage, position of cornea to palpebra inferior, canthal tilt, scleral show, ectropion and entropion. It was clearly distinguished between operated and contralateral eyelid, whether a transconjunctival or a subciliary approach was performed and amount of fracture. Our main interests were changes of the aforementioned parameters with regards to eyelid deformities. Results Surgery per se did not significantly influence eyelid deformities. However, the surgical approach selected significantly affected eye fissure index, lower iris coverage and rate of scleral show, indicating retraction of the lower eyelid. Conclusions The standardized measurements described here are accurate and objective to evaluate postoperative results. The subciliary approach included the highest risk of lower lid retraction as compared to transconjunctival approaches. Key words:Transconjunctical approach, subciliary approach, orbital floor fracture. PMID:26595833

  7. Spontaneously reduced isolated orbital roof fracture.

    PubMed

    Itinteang, Tinte; Lambe, Gerald Francis; MacKinnon, Craig; Agir, Hakan

    2012-07-01

    We report a case of a spontaneously reduced isolated orbital roof blow-in fracture with resolution of associated diplopia and blepharoptosis highlighting the need for a low threshold for reimaging this cohort of facial fracture patients. PMID:22801127

  8. A Wrapping Method for Inserting Titanium Micro-Mesh Implants in the Reconstruction of Blowout Fractures

    PubMed Central

    Choi, Tae Joon; Yang, Won Yong; Kang, Sang Yoon

    2016-01-01

    Titanium micro-mesh implants are widely used in orbital wall reconstructions because they have several advantageous characteristics. However, the rough and irregular marginal spurs of the cut edges of the titanium mesh sheet impede the efficacious and minimally traumatic insertion of the implant, because these spurs may catch or hook the orbital soft tissue, skin, or conjunctiva during the insertion procedure. In order to prevent this problem, we developed an easy method of inserting a titanium micro-mesh, in which it is wrapped with the aseptic transparent plastic film that is used to pack surgical instruments or is attached to one side of the inner suture package. Fifty-four patients underwent orbital wall reconstruction using a transconjunctival or transcutaneous approach. The wrapped implant was easily inserted without catching or injuring the orbital soft tissue, skin, or conjunctiva. In most cases, the implant was inserted in one attempt. Postoperative computed tomographic scans showed excellent placement of the titanium micro-mesh and adequate anatomic reconstruction of the orbital walls. This wrapping insertion method may be useful for making the insertion of titanium micro-mesh implants in the reconstruction of orbital wall fractures easier and less traumatic. PMID:26848451

  9. A Wrapping Method for Inserting Titanium Micro-Mesh Implants in the Reconstruction of Blowout Fractures.

    PubMed

    Choi, Tae Joon; Burm, Jin Sik; Yang, Won Yong; Kang, Sang Yoon

    2016-01-01

    Titanium micro-mesh implants are widely used in orbital wall reconstructions because they have several advantageous characteristics. However, the rough and irregular marginal spurs of the cut edges of the titanium mesh sheet impede the efficacious and minimally traumatic insertion of the implant, because these spurs may catch or hook the orbital soft tissue, skin, or conjunctiva during the insertion procedure. In order to prevent this problem, we developed an easy method of inserting a titanium micro-mesh, in which it is wrapped with the aseptic transparent plastic film that is used to pack surgical instruments or is attached to one side of the inner suture package. Fifty-four patients underwent orbital wall reconstruction using a transconjunctival or transcutaneous approach. The wrapped implant was easily inserted without catching or injuring the orbital soft tissue, skin, or conjunctiva. In most cases, the implant was inserted in one attempt. Postoperative computed tomographic scans showed excellent placement of the titanium micro-mesh and adequate anatomic reconstruction of the orbital walls. This wrapping insertion method may be useful for making the insertion of titanium micro-mesh implants in the reconstruction of orbital wall fractures easier and less traumatic. PMID:26848451

  10. Orbital fracture deterioration after scuba diving.

    PubMed

    Nakatani, Hiroko; Yoshioka, Nobutaka

    2009-07-01

    Sinus barotrauma is a common disease in divers. However, it is not familiar to maxillofacial surgeon. We presented orbital fracture deterioration by sinus barotrauma in scuba diving and a review of literatures. We also discussed the clinical features, the prevention, and the possible mechanism of orbital fracture deterioration after scuba diving. PMID:19625851

  11. Orbital Fracture: Significance of lateral wall

    PubMed Central

    Alsuhaibani, Adel H.

    2010-01-01

    The lateral orbital wall is the strongest among other orbital walls. However, it is commonly fractured in the setting of severe facial trauma. The fracture usually occurs at the sphenozygomatic suture line. In general, patients with lateral wall fractures are commonly young male who may present with mid facial swelling and some degree of deformity. In some cases, lateral orbital wall fracture may be associated with visual loss or change in mental status due to associated intracranial injury. Imaging studies with computed tomography is important in the proper diagnosis and planning of the surgical intervention. Management of intracranial or eye injuries should be undertaken on emergent basis. Thereafter, significantly displaced lateral wall fractures need to be repaired on timely basis. Proper realignment of the plane of the lateral orbital wall at the sphenozygomatic suture along with the other complex articulations of the zygomatic bone is necessary for proper functional and aesthetic outcome. PMID:23960875

  12. Surgical treatment of orbital floor fractures.

    PubMed

    Rankow, R M; Mignogna, F V

    1975-01-01

    Ninety patients with orbital floor fractures were treated by the Otolaryngology Service of the Columbia-Presbyterian Medical Center. Of these 90 patients, 58 were classified as coexisting and 32 as isolated. All fractures with clinical symptoms and demonstrable x-ray evidence should be explored. Despite negative findings by routine techniques, laminography may confirm fractures in all clinically suspicious cases. In this series, 100% of the patients explored had definitive fractures. A direct infraorbital approach adequately exposes the floor of the orbit. An effective and cosmetic subtarsal incision was utilized. Implants were employed when the floor could not be anatomically reapproximated or the periorbita was destroyed. PMID:1119982

  13. A case of acquired Brown syndrome after surgical repair of a medial orbital wall fracture.

    PubMed

    Seo, Il-Hun; Rhim, Jay-Won; Suh, Young-Woo; Cho, Yoonae A

    2010-02-01

    A case of acquired Brown syndrome caused by surgical repair of medial orbital wall fracture is reported in the present paper. A 23-year-old man presented at the hospital with right periorbital trauma. Although the patient did not complain of any diplopia, the imaging study revealed a blow-out fracture of the medial orbital wall. Surgical repair with a calvarial bone autograft was performed at the department of plastic surgery. The patient was referred to the ophthalmologic department due to diplopia that newly developed after surgery. The prism cover test at distant fixation showed hypotropia of the right eye, which was 4 prism diopters (PD) in primary gaze, 20 PD in left gaze, while orthophoric in right gaze. Eye movement of the right eye was markedly limited on elevation in adduction with normal elevation in abduction with intorsion in the right eye present. Forced duction test of the right eye showed restricted elevation in adduction. Computerized tomography scan of the orbits showed the right superior oblique muscle was entrapped between the autografted bone fragment and posterior margin of the fracture. When repairing medial orbital wall fracture that causes Brown syndrome, surgeons should always be careful of entrapment of the superior oblique muscle if the implant is inserted without identifying the superior and posterior margin of the orbital fracture site. PMID:20157416

  14. Natural course of orbital roof fractures.

    PubMed

    Stam, Liselotte H M; Wolvius, Eppo B; Schubert, Warren; Koudstaal, Maarten J

    2014-12-01

    The natural course of several isolated and nonisolated orbital roof fractures is reported, by showing four cases in which a "wait and see" policy was followed. All four cases showed spontaneous repositioning and stabilizing of the fracture within less than a year. This might be explained by the equilibrium between the intraorbital and intracranial pressures. PMID:25383150

  15. Management of complex orbital fractures.

    PubMed

    Bhatti, N; Kanzaria, A; Huxham-Owen, N; Bridle, C; Holmes, S

    2016-09-01

    The treatment of orbital injuries has evolved considerably over the last two decades. We describe strategies involved in the emergency management of orbital injuries, the use of imaging, preformed and customised materials for reconstruction, and endoscopic techniques. PMID:27268464

  16. Blow-in fracture of the orbit.

    PubMed

    Hwang, Kun; Kim, Han Joon; Lee, Hong Sik

    2013-01-01

    We report 2 patients with blow-in fractures of the orbital floor caused by different mechanisms. In a 17-year-old boy, a sudden impact was given to the anterior maxillary wall and caused a depression fracture of a maxilla, yet the infraorbital rim remained intact. We think fragments of the orbital floor were forced into the orbit by a sudden increase in pressure in the maxillary sinus in this patient. In a 51-year-old man, the impact of a force was on the laterosuperior part of the zygoma, which pushed the zygoma medially. These 2 cases represent 2 different mechanisms of blow-in fractures of the orbital floor. PMID:24036789

  17. An anomalous case of an indirect orbital floor fracture.

    PubMed

    Nicolotti, Matteo; Poglio, Giuseppe; Grivetto, Fabrizio; Benech, Arnaldo

    2014-09-01

    Fractures of the orbital floor are common in facial trauma. Those that comprise only the orbital floor are called indirect fractures or pure internal orbital floor fractures. We present the case of an indirect fracture of the orbital floor after direct trauma to the back of the head caused by a bicycle accident. To the best of our knowledge this is the first time that this mechanism for such a fracture has been reported. PMID:24742591

  18. Infraorbital Nerve Block for Isolated Orbital Floor Fractures Repair: Review of 135 Consecutive Cases

    PubMed Central

    Spinelli, Giuseppe; Rocchetta, Davide; Carnevali, Giulia; Valente, Domenico; Conti, Marco

    2014-01-01

    Background: Orbital blowout fractures can be managed by several surgical specialties including plastic and maxillofacial surgery, otolaryngology, and ophthalmology. Recommendations for surgical fracture repair depend on a combination of clinical and imaging studies to evaluate muscle/nerve entrapment and periorbital tissue herniation. Methods: The aim of this study was to verify the applicability of regional anesthesia when repairing orbital floor fractures. A retrospective chart review was performed for isolated orbital floor fractures treated at the Department of Maxillofacial Surgery in Florence between May 2011 and July 2012. The study included 135 patients who met the inclusion criteria: 96 subjects were male (71%) and 39 were female (29%). The mean age was 45.3 years, ranging from 16 to 77 years. Results: The results revealed that isolated anterior orbital floor fractures can be safely repaired under regional and local anesthesia. Regional and local anesthesia should be combined with intravenous sedation when the fracture involves the posterior floor. The surgical outcome was comparable to the outcome achieved under general anesthesia. There was a lower rate of surgical revisions due to concealed malposition or entrapment of the inferior rectus muscle (19% vs 22%). However, this result was not statistically significant (P > 0.05). Conclusions: There are several advantages to surgically repairing isolated orbital floor fractures under regional and local anesthesia that include the following: surgeons can check the surgical outcome (enophthalmos and extrinsic ocular muscles function) intraoperatively, thereby reducing the reoperation rate; patient discomfort due to general anesthesia is eliminated; and the hospital stay is reduced, thus decreasing overall healthcare costs. PMID:25289294

  19. Direct oblique sagittal CT of orbital wall fractures

    SciTech Connect

    Ball, J.B. Jr.

    1987-03-01

    Direct oblique sagittal CT was used to evaluate trauma to 77 orbits. Sixty-seven orbital wall fractures with intact orbital rims (36 floor, 22 medial wall, nine roof) were identified in 47 orbits. Since persistent diplopia and/or enophthalmos may warrant surgical repair of orbital floor fractures, optimal imaging should include an evaluation of extraocular muscle status, the nature and amount of displaced orbital contents, and an accurate definition of fracture margins. For orbital floor fractures, a combination of the direct oblique sagittal and direct coronal projections optimally displayed all fracture margins, the fracture's relationship to the inferior orbital rim and medial orbital wall, and the amount of displacement into the maxillary sinus. Inferior rectus muscle status with 36 floor fractures was best seen on the direct oblique sagittal projection in 30 fractures (83.3%) and was equally well seen on sagittal and coronal projections in two fractures (5.5%). Floor fractures were missed on 100% of axial, 5.5% of sagittal, and 0% of coronal projections. Since the direct oblique sagittal projection complements the direct coronal projection in evaluating orbital floor fractures, it should not be performed alone. A technical approach to the CT evaluation or orbital wall fractures is presented.

  20. Management of orbital fractures: challenges and solutions.

    PubMed

    Boyette, Jennings R; Pemberton, John D; Bonilla-Velez, Juliana

    2015-01-01

    Many specialists encounter and treat orbital fractures. The management of these fractures is often challenging due to the impact that they can have on vision. Acute treatment involves a thorough clinical examination and management of concomitant ocular injuries. The clinical and radiographic findings for each individual patient must then be analyzed for the need for surgical intervention. Deformity and vision impairment can occur from these injuries, and while surgery is intended to prevent these problems, it can also create them. Therefore, surgical approach and implant selection should be carefully considered. Accurate anatomic reconstruction requires complete assessment of fracture margins and proper implant contouring and positioning. The implementation of new technologies for implant shaping and intraoperative assessment of reconstruction will hopefully lead to improved patient outcomes. PMID:26604678

  1. Management of orbital fractures: challenges and solutions

    PubMed Central

    Boyette, Jennings R; Pemberton, John D; Bonilla-Velez, Juliana

    2015-01-01

    Many specialists encounter and treat orbital fractures. The management of these fractures is often challenging due to the impact that they can have on vision. Acute treatment involves a thorough clinical examination and management of concomitant ocular injuries. The clinical and radiographic findings for each individual patient must then be analyzed for the need for surgical intervention. Deformity and vision impairment can occur from these injuries, and while surgery is intended to prevent these problems, it can also create them. Therefore, surgical approach and implant selection should be carefully considered. Accurate anatomic reconstruction requires complete assessment of fracture margins and proper implant contouring and positioning. The implementation of new technologies for implant shaping and intraoperative assessment of reconstruction will hopefully lead to improved patient outcomes. PMID:26604678

  2. Orbital fractures due to domestic violence: an epidemiologic study.

    PubMed

    Goldberg, Stuart H.; McRill, Connie M.; Bruno, Christopher R.; Ten Have, Tom; Lehman, Erik

    2000-09-01

    Domestic violence is an important cause of orbital fractures in women. Physicians who treat patients with orbital fractures may not suspect this mechanism of injury. The purpose of this study was to assess the association between domestic violence and orbital fractures. A medical center-based case-control study with matching on age and site of admission was done. Medical center databases were searched using ICD-9 codes to identify all cases of orbital fractures encountered during a three-year period. Medical records of female patients age 13 and older were reviewed along with those of age, gender and site of admission matched controls. A stratified exact test was employed to test the association between domestic violence and orbital fracture. Among 41 adult female cases with orbital fractures treated at our medical center, three (7.3%) reported domestic violence compared to zero among the matched controls (p = 0.037). We believe that domestic violence may be under-reported in both orbital fracture cases and controls. This may result in an underestimate of the orbital fracture versus domestic violence association. Domestic violence is a serious women's health and societal problem. Domestic violence may have a variety of presentations, including illnesses and injuries. Orbital fracture is an identifiable manifestation of domestic violence. Domestic violence is more likely to be detected in adult female hospital patients with orbital fracture than in matched controls with any other diagnosis. Physicians who treat patients with orbital fractures should be familiar with this mechanism of injury. PMID:12045943

  3. Lateral cortex blowout during PFNA blade insertion in a subtrochanteric fracture---Should bone quality determine the type of nail used?

    PubMed

    Kini, Sunil-Gurpur; Hin, Lai Choon; Haniball, Jikku

    2015-01-01

    Subtrochanteric fractures pose a therapeutic challenge to the surgeons. With the advent of proximal femoral nails, most of the cases are treated with nailing. Newer nails like proximal femoral nail antirotation (PFNA) require the blade to be directly hammered into the bone compared to older nails where the screws are drilled and tapped before insertion. We report one such case in a middle aged female that had intraoperative lateral cortex blowout during PFNA blade insertion in a sclerotic bone. This occurrence to the best of our knowledge is unreported in literature. It is therefore imperative to consider the quality of bone before a decision is made on the implant chosen. PMID:26511307

  4. Medpor Implant Fixation Using Fibrin Glue in the Treatment of Medial Orbital Wall Fracture.

    PubMed

    Kang, Nakheon; Song, Seung Han; Kyung, Hyunwoo; Oh, Sang-Ha

    2015-06-01

    The optimal treatment modalities are determined based on the symptoms and degree of the bone defects in patients with medial orbital wall blowout fracture. Most of the patients in this series underwent implant surgery. However, there are many patients whose implants were not fixed during surgery. Therefore, some patients who had implant migration occurred had been reported. We have therefore used methods for applying fibrin glue (Tisseel, Baxter Healthcare, Norfolk, United Kingdom) for the fixation of implant. Between 2007 and 2013, a total of 168 patients underwent porous polyethylene orbital implant (Medpor) surgery with the application of Tisseel. All the patients underwent surgical treatments via a transcaruncular approach, for which the Medpor was used. Postoperative complications include 6 cases of the limitation of extraoccular movement, 10 cases of diplopia, and 7 cases of enophthalmos. However, there were no specific complications caused by Tisseel. All the patients were satisfied with the treatment outcomes. In this study, we report the usefulness of Tisseel in the fixation of the medial orbital wall fracture using the Medpor implant with a review of literatures. PMID:26080196

  5. Mediastinal emphysema following fracture of the orbital floor

    PubMed Central

    Abdelrahman, Husham; Shunni, Adam; El-Menyar, Ayman; Ajaj, Ahmad; Afifi, Ibrahim; Zarour, Ahmad; Al-Thani, Hassan

    2014-01-01

    Pneumomediastinum (PM) is mainly an atypical finding among traumatic neck or thoracic injury patients. Moreover, PM secondary to isolated orbital floor fracture remains a rare event which is infrequently associated with severe complications such as mediastinitis, airway obstruction and pneumothorax. Herein, we report an atypical case of mediastinal emphysema consequent to orbital floor fracture along with review of the literature. PMID:24876504

  6. Delayed Periorbital Abscess after Silicone Implant to Orbital Floor Fracture.

    PubMed

    Dedhia, Raj; Tollefson, Travis T

    2016-06-01

    There is a lack of consensus regarding preferred implant materials for orbital floor fracture reconstruction, leading to surgeon- and institution-dependent preferences. A variety of implants are used for orbital floor fracture reconstruction, each with their own complication profile. Knowledge of different implant materials is critical to identifying complications when they present. We report a delayed periorbital abscess 5 years after orbital floor reconstruction using a silicone implant. PMID:27162580

  7. Orbital Roof Fractures: A Clinically Based Classification and Treatment Algorithm.

    PubMed

    Connon, Felicity Victoria; Austin, S J B; Nastri, A L

    2015-09-01

    Orbital roof fractures are relatively uncommon in craniofacial surgery but present a management challenge due to their anatomy and potential associated injuries. Currently, neither a classification system nor treatment algorithm exists for orbital roof fractures, which this article aims to provide. This article provides a literature review and clinical experience of a tertiary trauma center in Australia. All cases admitted to the Royal Melbourne Hospital with orbital roof fractures between January 2011 and July 2013 were reviewed regarding patient characteristics, mechanism, imaging (computed tomography), and management. Forty-seven patients with orbital roof fractures were treated. Three of these were isolated cases. Forty were male and seven were female. Assault (14) and falls (13) were the most common causes of injury. Forty-two patients were treated conservatively and five had orbital roof repairs. On the basis of the literature and local experience, we propose a four-point system, with subcategories allowing for different fracture characteristics to impact management. Despite the infrequency of orbital roof fractures, their potential ophthalmological, neurological, and functional sequelae can carry a significant morbidity. As such, an algorithm for management of orbital roof fractures may help to ensure appropriate and successful management of these patients. PMID:26269727

  8. Reduction of nasal orbital fractures and simultaneous dacryocystorhinostomy.

    PubMed

    Smith, B

    1976-01-01

    A technique for restoration of structure and function in naso-orbital fractures has been described. Three case reports demonstrate a few of the final results. The case reports also indicate that many of these fractures require late definitive surgery in spite of optimal surgical treatment immediately subsequent to injury. PMID:1020097

  9. Spontaneous Resorption of a Penetrating Orbital Bone Fracture Fragment.

    PubMed

    Campbell, Ashley A; Cunnane, Mary Elizabeth; Dunn, Gavin P; Gray, Stacy Tutt; Lefebvre, Daniel R

    2015-01-01

    The authors describe a 20-year-old man who sustained multiple facial fractures in a high-speed motor vehicle crash, including a bone fragment from a skull base fracture that penetrated the orbital soft tissues superomedially. Serial CT scans documented spontaneous resorption over a 6-month period. While it is known that autologous bone grafts used in craniofacial reconstruction exhibit variable amounts of bone resorption, the complete resorption of an intraorbital fracture fragment has not been documented in the literature. His clinical care and the report of his case were undertaken in a fashion in accordance with the principles of the Health Insurance Portability and Accountability Act regulations. PMID:24833452

  10. Transantral Orbital Floor Fracture Repair Using a Folded Silastic Tube

    PubMed Central

    Kim, Joo Yeon; Choi, Gwan

    2015-01-01

    Objectives The purpose of this study was to evaluate the advantages and limitations of using a silicon tube to support the fractured orbital floor by a transantral approach. Methods A retrospective study was conducted from January 2000 to December. 2011 in 51 patients with pure orbital floor fractures. The patients underwent reduction surgery via a transantral approach for inserting a folded silastic tube to support the fractured orbital floor in the maxillary sinus. A chart review of preoperative and postoperative ocular symptoms, operation records, and complications was maintained. Results In 18 out of 25 patients with diplopia, postoperative improvement was seen. In 13 out of 15 patients with extraocular muscle limitation, postoperative improvement was seen. Enophthalmos resolved postoperatively in four of five patients. Postsurgical complications occurred in three patients: an overcorrection, an infection in the maxillary sinus, and an implant extrusion, all of which were resolved by revision surgeries. Conclusion During the course of the study, we sensed reduction using a folded silastic tube via a transantral approach as an easy and effective technique with good postoperative results, and minimal implant related complications. This novel procedure is recommended as a surgical option for the reduction of orbital floor fractures. PMID:26330920

  11. Materials used for reconstruction after orbital floor fracture.

    PubMed

    Avashia, Yash J; Sastry, Ananth; Fan, Kenneth L; Mir, Haaris S; Thaller, Seth R

    2012-11-01

    Advances in biotechnology continue to introduce new materials for reconstruction of orbital floor fractures. Which material is best fit for orbital floor reconstruction has been a controversial topic. Individual surgeon preferences have been supported by inconsistent inconclusive data. The purpose of this study was to assess and analyze published evidence supporting various materials used for orbital floor reconstruction and to develop a decision-making algorithm for clinical application. A systematic literature review was performed from which 48 studies were selected after primary and secondary screening based on set inclusion and exclusion criteria. This cumulatively included 3475 separate orbital floor reconstructions. Results revealed risk and benefit profiles for all materials. Autologous calvarial bone grafts, porous polyethylene, and polydioxanone (PDS) were most widely used for orbital floor reconstruction. Increased infection rates were reported with polyglactin 910/PDS composites and silastic rubber. Ocular motility was reduced most with lyophilized dura and PDS. Preoperative and postoperative rates for diplopia and enophthalmos varied among the materials. In conclusion, our results revealed continued inadequate evidence to exclusively support the use of any one biomaterial/implant for orbital floor reconstruction. Results have served to create a decision-making algorithm for clinical application. Our authors propose certain parameters for future studies seeking to demonstrate a comparison between 2 or more materials for orbital floor reconstruction. PMID:23154365

  12. Mucocele After Orbital Fracture Repair Masquerading as Optic Neuritis.

    PubMed

    Park, Jongyeop; Kim, Jinhyun; Choi, Jinsu; Kim, Hochang

    2016-06-01

    The authors report a patient of mucocele formation after orbital wall fracture repair masquerading as optic neuritis.A 38-year-old man with a history of medial orbital wall fracture repair with an alloplastic implant 10 years previously, presented with left visual disturbance and mild ocular pain with movement of the left eye of 3-day duration, and a relative afferent papillary defect in his left eye. He reported having cold symptoms 2 weeks before presentation. His symptoms were typical of retrobulbar optic neuritis. Under suspicion of optic neuritis, computed tomography and magnetic resonance imaging were performed and revealed a large cyst in the sphenoid sinus and ethmoid sinus, just behind the alloplastic implant, that was compressing the medial rectus muscle and optic nerve of the left eye. The patient underwent endoscopic marsupialization of the cyst. Subsequent histologic examinations revealed a cyst lined with ciliated pseudostratified columnar epithelium. The patient had an uncomplicated postoperative course and the visual disturbance resolved. For patients who present solely with optic neuropathy after orbital fracture repair, it is important to be vigilant of potentially rare cause, mucocele formation. PMID:27171955

  13. Lateral view of facial fractures: new observations

    SciTech Connect

    Daffner, R.H.; Apple, J.S.; Gehweiler, J.A.

    1983-09-01

    Traditional plain film evaluation of facial fractures includes a lateral view of the face. This projection is often not exploited to its full potential because the many overlapping shadows are perceived to detract from its usefulness. To assess the value of this view, the authors reviewed the lateral facial films of 50 patients with a variety of fractures including 25 orbital blow-out fractures, 27 zygomaticomaxillary complex fractures, and 17 maxillary (including Le Fort) fractures. Three observations were encountered: orbital floor displacement in 60% of orbital fractures; malar strut displacement in 41% of zygomaticomaxillary complex fractures; and maxillary wall displacement in 76% of maxillary fractures. The presence of any of these structural displacements, either alone or in combination, provides further direct evidence of skeletal disruption and should serve to augment the findings observed on frontal views.

  14. Peribulbar anesthesia for the repair of orbital floor fractures.

    PubMed

    Kezirian, G M; Hill, F D; Hill, F J

    1991-10-01

    Four patients underwent successful repair of an isolated orbital floor fracture under local anesthesia. The surgical approach was by antero-inferior orbitotomy, with placement of a Nylamid plate (S Jackson Inc, Washington, DC). The anesthetic technique used was a peribulbar and infratrochlear nerve block with local supplementation. Digital control of the globe was maintained during the peribulbar injection to prevent ocular perforation. We conclude that local anesthetic for this procedure in carefully selected cases is safe and efficacious, avoiding the morbidity of a general anesthetic. PMID:1961618

  15. Combined Orbital Fractures: Surgical Strategy of Sequential Repair

    PubMed Central

    Hur, Su Won; Kim, Sung Eun; Chung, Kyu Jin; Lee, Jun Ho; Kim, Tae Gon

    2015-01-01

    Background Reconstruction of combined orbital floor and medial wall fractures with a comminuted inferomedial strut (IMS) is challenging and requires careful practice. We present our surgical strategy and postoperative outcomes. Methods We divided 74 patients who underwent the reconstruction of the orbital floor and medial wall concomitantly into a comminuted IMS group (41 patients) and non-comminuted IMS group (33 patients). In the comminuted IMS group, we first reconstructed the floor stably and then the medial wall by using separate implant pieces. In the non-comminuted IMS group, we reconstructed the floor and the medial wall with a single large implant. Results In the follow-up of 6 to 65 months, most patients with diplopia improved in the first-week except one, who eventually improved at 1 year. All patients with an EOM limitation improved during the first month of follow-up. Enophthalmos (displacement, 2 mm) was observed in two patients. The orbit volume measured on the CT scans was statistically significantly restored in both groups. No complications related to the surgery were observed. Conclusions We recommend the reconstruction of orbit walls in the comminuted IMS group by using the following surgical strategy: usage of multiple pieces of rigid implants instead of one large implant, sequential repair first of the floor and then of the medial wall, and a focus on the reconstruction of key areas. Our strategy of step-by-step reconstruction has the benefits of easy repair, less surgical trauma, and minimal stress to the surgeon. PMID:26217562

  16. Diagnosis and imaging of orbital roof fractures: a review of the current literature.

    PubMed

    Righi, Stefano; Boffano, Paolo; Guglielmi, Valeria; Rossi, Paolo; Martorina, Massimo

    2015-03-01

    Isolated adult orbital roof fractures are uncommon, and the majority of them are typically associated with extensive craniofacial, ophthalmologic, and other body injuries. It is crucial to make an appropriate diagnosis of orbital roof fracture if present. Therefore, the aim of this article was to review the current literature about diagnosis and imaging of orbital roof fracture to obtain current indications. A systematic review of articles published between January 1990 and August 2013 was performed. Early diagnosis of orbital roof fractures can reduce the incidences of intracranial and ocular complications. CT scan still plays a major role in the assessment of acute orbital trauma. Careful assessment and reporting of the CT scan findings are important. In fact, the clinicians managing the patient with acute head and facial trauma should be familiar with the common findings of CT scan in case of an orbital roof fracture. PMID:25582115

  17. Endoscopic orbital decompression of an isolated medial orbital wall fracture: a case report.

    PubMed

    Gultekin, Erdogan; Ciftci, Zafer; Develioglu, Omer N; Celik, Oner; Yener, Murat; Kulekci, Mehmet

    2011-12-01

    Motor vehicle and bicycle accidents are the most common causes of blunt head trauma. Other common etiologies are falls, physical violence, and sports accidents. Blunt trauma toward the superior orbital rim, lateral orbital rim, frontal region, and cranium may lead to intraorbital hematoma. A fracture following the blunt head trauma may form a one-way valve, which leads to orbital emphysema and a more pronounced increase in orbital pressure. Increased tissue pressure in an enclosed space will eventually lead to an inevitable decrease in tissue perfusion. It is important to treat the patient within the first 48 hours following the trauma, which is accepted as the "critical period." In this report we present a case involving a 42-year-old man who was admitted to our clinic with left periorbital pain, edema, proptosis, and blurred vision after experiencing physical violence. The medical history and physical examination findings, along with imaging studies and a description of the endoscopic orbital decompression procedure within the first 24 hours, are reported. PMID:22180121

  18. Evaluation of the lateral orbital approach in management of zygomatic bone fractures

    PubMed Central

    Thangavelu, K; Ganesh, N Sayee; Kumar, J Arun; Sabitha, S; Nikil

    2013-01-01

    Zygomatic maxillary fractures, also known as tripod fractures, are usually the result of a direct blow to the body of the zygoma. Tripod fracture consists of (a) zygomatic arch fracture, (b) fracture of the lateral orbital wall, and (c) fracture of the inferior orbital floor. The purpose of this study is to evaluate the functional and esthetic outcome following this lateral orbital approach in the management of zygoma fracture. This study was carried out in VMS Dental College, Salem, and in a private hospital. This study was based on the experience gained from a retrospective study of the 30 lateral orbital approaches that were used in 30 patients with fractures of the zygomatic complex, which were conducted for a period of 8 years between January 2003 and January 2011. In the retrospective study, all the 30 patients were able to open the mouth completely; eyeball movements were normal; esthetically, all patients appeared normal. There were no sinusitis or visual problems in any of the studied patients. We conclude that the lateral orbital approach is an ideal option in reduction and treatment of zygomatic bone and arch fractures. PMID:23633846

  19. Treatment of Orbital Roof Blow-Up Fracture Using a Superior Blepharoplasty Incision.

    PubMed

    Matsuzaki, Kyoichi; Enomoto, Sayaka; Aoki, Tomoko

    2015-06-01

    In orbital roof blow-up fractures, reduction can be achieved easily using an approach from the anterior cranial fossa but the procedure is highly invasive. In contrast, an orbital approach using a superior blepharoplasty incision is minimally invasive. However, if bone fragments are adhered to the dura mater, there is a risk of dura mater injury when fragments are moved for reduction. In blow-in fractures, reduction is performed by pushing the bone fragments against the anterior cranial fossa. In contrast, the procedure is difficult for blow-up fractures because bone fragments must be pulled out into the orbit through the anterior cranial fossa. Orbital blow-up fractures are often associated with intracranial injuries and frequently treated by an approach from the anterior cranial fossa. There has not yet been a report that discusses whether reduction of bone fragments should be performed in blow-up fracture without intracranial injury. In this report, we describe two cases of orbital roof blow-up fracture that did not require treatment for intracranial injury and that were treated using an orbital approach. The treatment involved only the release of orbital fat entrapped between bone fragments and did not involve reduction. The treatment outcomes were good in both cases. PMID:25836594

  20. Comparative Study of Naugle and Hertel Exophthalmometry in Orbitozygomatic Fracture.

    PubMed

    Jeon, Hong Bae; Kang, Dong Hee; Oh, Sang Ah; Gu, Ja Hea

    2016-01-01

    Accurate perioperative evaluation of enophthalmos is important to determine the adequacy of surgical repair in orbitozygomatic fracture. In this study, the authors evaluated the degree of enophthalmos using Hertel and Naugle exophthalmometry in patients with pure blowout fracture and orbitozygomatic fracture, and compared the results. Fifty patients were divided into 2 groups: pure blowout fracture (Group A: control group, 25 patients) and orbitozygomatic fracture with displaced lateral orbital rim (Group B: experimental group, 25 patients). Hertel and Naugle scales were measured before and 6 months after surgery. The degree of lateral orbital rim advancement was assessed by comparing the difference between the perioperative change of the Hertel and Naugle scales. In Group A, the difference between the pre- and postoperative scales in the 2 exophthalmometry was statistically significant (P < 0.05). In Group B, the Hertel scale increased from -0.20 to -0.16 mm, with an insignificant difference between pre- and postoperative values (P > 0.05) and the Naugle scale increased from -0.88 to -0.20 mm, with a significant difference (P < 0.05). The Δ Hertel scale differed from the Δ Naugle scale by a mean of -0.64 mm, which represents the degree of lateral orbital rim advancement. Naugle exophthalmometry is a more reliable method for evaluation of enophthalmos in lateral orbital rim displaced orbitozygomatic fractures than Hertel exophthalmometry. The degree of lateral orbital rim advancement can be assessed by combined use of the Hertel and Naugle exophthalmometry in orbitozygomatic fractures. PMID:26674913

  1. "Roller coaster maneuver via lateral orbital approach" for reduction of isolated zygomatic arch fractures.

    PubMed

    Pilanci, Ozgur; Basaran, Karaca; Datli, Asli; Kuvat, Samet Vasfi

    2013-11-01

    Numerous techniques have been reported for the reduction of zygomatic arch fractures. In this article, we aimed to describe a technique we named as "roller coaster maneuver via lateral orbital approach" to closed reduction of the isolated-type zygomatic arch fractures. Surgical outcomes of 14 patients treated with this method were outlined. PMID:24220411

  2. Successful application of endoscopic modified medial maxillectomy to orbital floor trapdoor fracture in a pediatric patient.

    PubMed

    Matsuda, Yasunori; Sakaida, Hiroshi; Kobayashi, Masayoshi; Takeuchi, Kazuhiko

    2016-10-01

    Although surgical treatment of orbital floor fractures can be performed by many different approaches, the application of endoscopic modified medial maxillectomy (EMMM) for this condition has rarely been described in the literature. We report on a case of a 7-year-old boy with a trapdoor orbital floor fracture successfully treated with the application of EMMM. The patient suffered trauma to the right orbit floor and the inferior rectus was entrapped at the orbital floor. Initially, surgical repair via endoscopic endonasal approach was attempted. However, we were unable to adequately access the orbital floor through the maxillary ostium. Therefore, an alternative route of access to the orbital floor was established by EMMM. With sufficient visualization and operating space, the involved orbital content was completely released from the entrapment site and reduced into the orbit. To facilitate wound healing, the orbital floor was supported with a water-inflated urethral balloon catheter for 8 days. At follow-up 8 months later, there was no gaze restriction or complications associated with the EMMM. This case illustrates the efficacy and safety of EMMM in endoscopic endonasal repair of orbital floor fracture, particularly for cases with a narrow nasal cavity such as in pediatric patients. PMID:26926254

  3. Mydriasis during Orbital Floor Fracture Reconstruction: A Novel Diagnostic and Treatment Algorithm

    PubMed Central

    Yeo, Matthew S.; Al-Mousa, Radwan; Sundar, Gangadhara; Lim, Thiam Chye

    2010-01-01

    Orbital floor fractures are the most commonly encountered traumatic fractures in the facial skeleton. Mydriasis that is detected during orbital floor fracture reconstruction may cause significant distress to surgeons, as it may be associated with sinister events such as visual loss. It is not an uncommon problem; previous studies have shown the incidence of mydriasis to be 2.1%. The combination of careful preoperative evaluation and planning, as well as specific intraoperative investigations when mydriasis is encountered, can be immensely valuable in allaying surgeons' anxiety during orbital floor fracture reconstruction. In this review article, the authors discuss the common causes of mydriasis and present a novel systematic approach to its diagnostic evaluation devised by our unit that has been successfully implemented since 2008. PMID:22132259

  4. Kuwait; The blowouts are history

    SciTech Connect

    Not Available

    1992-01-01

    This paper reports on the capping of oil well blowouts in Kuwait. It reports on how access to the wells was gained, the well kill methods used, and future work that must be done in order to restore productivity.

  5. Longitudinal tear of the inferior rectus muscle in orbital floor fracture.

    PubMed

    Kashima, Tomoyuki; Akiyama, Hideo; Kishi, Shoji

    2012-06-01

    We report a case of longitudinal avulsion of the inferior rectus muscle following orbital floor fracture and describe its clinical presentation, computed tomography (CT) features and management. A 53-year-old man felt vertical diplopia in all gaze immediately after the trauma. Orthoptic assessment showed left over right hypertropia of 20 prism diopters and left exotropia of 10 prism diopters in primary position. The left orbital floor fracture and the prolapse of orbital contents into the maxillary sinus were presented by CT. Exploration of the orbit was performed under general anesthesia. The displaced bone fragment was elevated and repositioned below the slastic implant. Diplopia continued in all directions of gaze, although the impairment of depression was reduced postoperatively. A residual left hypertropia of 10 prism diopters and exotropia of 10 prism diopters was present in primary position 1 month after surgery, though there were no enopthalmos or worsening of hypesthesia. Repeated CT revealed the muscle avulsion of inferior rectus at the lateral portion of the belly. The avulsion of a small segment of the inferior rectus and its herniation into maxillary sinus in more posterior views was detected by review of the preoperative images. Muscle avulsion should be considered in the management of orbital fracture if orbital tissue entrapment and nerve paresis are excluded as causes of reduction in ocular motility. A thorough review of the imaging studies for possible muscle injury is required before surgery in all cases of orbital fracture. PMID:22551369

  6. Long-term infectious complications of using porous polyethylene mesh for orbital fracture reconstruction

    PubMed Central

    Song, Xuefei; Li, Lunhao; Sun, Yiyuan; Fan, Xianqun; Li, Zhengkang

    2016-01-01

    Abstract Porous polyethylene is a widely used implants in orbital reconstruction, on which comprehensive clinical analysis, various treatments, and different prognosis according to specific classification principles on long-term complications have not been reported. To investigate the new clinical symptoms, intraoperative findings, treatments, and outcomes of complications long period after previous surgery, resulting from the use of porous polyethylene mesh for orbital fracture reconstruction. A retrospective study was conducted on 21 patients at the Department of Ophthalmology, Shanghai Ninth People's Hospital with orbital complications after orbital fracture reconstruction with porous polyethylene mesh for 4 ± 2.2 years from 2011 to 2013. These data included new clinical symptoms after previous surgery, computerized tomography data, intraoperative findings, treatments, and outcomes. Data from 21 patients were analyzed in this study. Two patients received conservative treatment, while the other 19 patients underwent surgical approaches. Classification principles for orbital complications after orbital wall defect reconstruction with porous polyethylene mesh were formulated according to patients’ new clinical symptoms, computed tomography (CT), and intraoperative findings after previous surgery. In the last follow-up, 19 patients (90.5%) were cured or improved according to our assessment principle. The follow-up ranged from 3 to 45 months (35 months in average). According to specific classification for orbital complications resulting from the use of porous polyethylene mesh for orbital fracture reconstruction, various medical treatments should be carried out, and the prognosis may be different. PMID:27336867

  7. Spontaneous Decompression Fracture in Thyroid Eye Disease.

    PubMed

    Richardson, Marc A; Lewis, Kyle T

    2014-12-01

    This is a case of a 44-year-old female with a history of Graves' orbitopathy presented to the emergency department after waking from a nap with sudden onset of left facial and periorbital swelling, ecchymosis, and subconjunctival hemorrhage. A CT scan obtained in the emergency department revealed a left blowout fracture and enlarged extraocular muscles. The patient lives with her mother and both adamantly denied any trauma. The patient had sustained a spontaneous orbital fracture; a process reported but few times in the medical literature. PMID:25473888

  8. Retrocaruncular Approach for the Repair of Medial Orbital Wall Fractures: An Anatomical and Clinical Study

    PubMed Central

    Shen, Yun-Dun; Paskowitz, Daniel; Merbs, Shannath L.; Grant, Michael P.

    2014-01-01

    The aim of this article is to investigate a retrocaruncular approach for repairing medial orbital wall fractures. A total of 10 fresh cadaver orbits were dissected to investigate a transconjunctival approach to the orbit posterior to the caruncle. Medical records of consecutive patients with medial orbital wall fractures repaired via a retrocaruncular incision at Wilmer Eye Institute over a 10-year period were retrospectively reviewed. The study was approved by the Johns Hopkins Medical Institution's Institutional Review Board. Feasibility of this approach was clearly demonstrated on all cadavers. Horner muscle was observed to be directly attached to the caruncle and remained undisturbed throughout the retrocaruncular approach. For each of the 174 patients reviewed, this approach allowed successful access to the fracture and proper implant placement. The origin of the inferior oblique muscle was divided in only 19 patients. Sutures were not used for conjunctival incision closure in any patient. For 120 patients who underwent acute repair, the percentage with enophthalmos (≥ 2 mm) decreased from 34% preoperatively to 4% postoperatively; extraocular motility deficit decreased from 41 to 11%. Postoperative complications included recurrence of the preexisting retrobulbar hemorrhage, conjunctival granuloma, and temporary torsional diplopia, each in one patient. The retrocaruncular transconjunctival incision is an effective and safe approach for repairing medial orbital wall fractures with minimal complications. The retrocaruncular incision offers advantages over dividing the caruncle because Horner muscle is left undisturbed, and the incision heals well without suturing. PMID:26000079

  9. Split stack blowout prevention system

    SciTech Connect

    Crager, B.L.; Ray, D.R.; Steddum, R.E.

    1980-03-18

    A blowout prevention system for an offshore structure positioned on the underwater bottom in a body of water which contains moving ice masses that could force the structure off location wherein a surface blowout preventer stack for conventional well control is connected to the upper end of a riser with the lower end of the riser being disconnectably connected to a subsurface blowout preventer stack which provides the necessary well control should the structure be forced off location. The subsurface stack is positioned on a wellhead located in a chamber in the subsea bottom and is disconnectably connected to the riser so that the riser may be quickly removed from the subsea bottom should the structure be forced off location.

  10. Huge blowout reported in Uzbekistan

    SciTech Connect

    Not Available

    1992-04-27

    This paper reports that Moscow reports one of the largest oil well blowouts recorded on the territory of the former Soviet Union remained out of control during late April in Uzbekistan's Fergana Valley. The newspaper Trud the the well, now on fire, was flowing nearly 20,000 metric tons/day (146,000 b/d) of oil with a pressure of 10,300 psi. Located near the town of Mingbulak in Namanganskaya province, the well is near the Syr-Darya River. Initially unreported by the Moscow media, the blowout occurred Mar. 2. Besides personnel from Azerbaijan and other areas of the Commonwealth of Independent States, Uzbekistan invited American specialists to provide advice on how to control the blowout. However, Uzbek authorities had no hard currency to pay western firms.

  11. Temporal posttraumatic limited ocular movement with suspected trapdoor fracture

    PubMed Central

    Song, Young-Seok; Yokota, Harumasa; Ito, Haruna; Yoshida, Akitoshi

    2014-01-01

    Trapdoor fractures, or blowout fractures, result from muscle entrapment after orbital floor fractures. The incarcerated muscles may become necrotic because of ischemia; immediate surgery is recommended for symptomatic persistent diplopia or clinical evidence of entrapment. We report a case of spontaneous resolution of diplopia in a patient with a high suspicion of a trapdoor fracture. A 15-year-old girl presented with diplopia after being hit in the eye while playing volleyball. Computed tomography did not show a fractured orbital bone, but the forced duction test was positive when the left eye was pulled forward toward the left. Magnetic resonance imaging was negative for edema and inflammation in the extraocular muscles. With observation only, the diplopia resolved 2 weeks after onset. A negative forced duction test confirmed the resolution. Observation only may be appropriate in cases with posttraumatic limited ocular movement, after imaging has excluded an emergent condition. PMID:25170246

  12. Temporal posttraumatic limited ocular movement with suspected trapdoor fracture.

    PubMed

    Song, Young-Seok; Yokota, Harumasa; Ito, Haruna; Yoshida, Akitoshi

    2014-01-01

    Trapdoor fractures, or blowout fractures, result from muscle entrapment after orbital floor fractures. The incarcerated muscles may become necrotic because of ischemia; immediate surgery is recommended for symptomatic persistent diplopia or clinical evidence of entrapment. We report a case of spontaneous resolution of diplopia in a patient with a high suspicion of a trapdoor fracture. A 15-year-old girl presented with diplopia after being hit in the eye while playing volleyball. Computed tomography did not show a fractured orbital bone, but the forced duction test was positive when the left eye was pulled forward toward the left. Magnetic resonance imaging was negative for edema and inflammation in the extraocular muscles. With observation only, the diplopia resolved 2 weeks after onset. A negative forced duction test confirmed the resolution. Observation only may be appropriate in cases with posttraumatic limited ocular movement, after imaging has excluded an emergent condition. PMID:25170246

  13. Resolution of diplopia after repair of the deep orbit.

    PubMed

    Sleep, T J; Evans, B T; Webb, A A C

    2007-04-01

    The degree of resolution of diplopia after repair of a blow-out fracture of the orbital floor varies and depends on many factors. We present six patients, each of whom had extensive fractures of the floor of the orbit that extended posteriorly to its anatomical limit. The mean (range) time for the resolution of diplopia after reconstruction was 4.4 (1-7) months. We think that its slow resolution in these patients may require preoperative counselling, and also the postoperative management of patients with extensive disruptions of the floor of the orbit posterior to the anterior limit of the inferior orbital fissure (within the deep orbit) must be carefully planned. PMID:16814905

  14. Is Delayed Release of Superior Oblique Muscle Entrapment in Orbital Roof Fracture Worth Correcting?

    PubMed

    Sharma, Rohit; Muralidharan, Chiyyarath Gopalan; Roy, Indranil Deb; Janjani, Lalit

    2016-07-01

    Acquired Brown's syndrome is a rare entity. Delay in treatment can cause fibrosis or scarring with questionable prognosis of vertical diplopia. To the best of the knowledge of the authors the present case of 22-year-old male is the first in existing literature where delayed release of superior oblique muscle entrapment in orbital roof fracture was found to be an effective technique. PMID:27391521

  15. Offshore blowouts, data for risk assessment

    SciTech Connect

    Holand, P.

    1995-12-31

    Blowouts are, besides gas leakages, the major contributor to the total risk for offshore installations. Therefore, the blowout risk is always included in Quantitative Risk Analyses (QRAs) of offshore installations in the Norwegian Sector of the North Sea. SINTEF Offshore Blowout Database has existed since 1984 (until 1990 it was called Marintek`s blowout database). In 1990 the responsibility of the database was transferred to SINTEF Safety and Reliability. Throughout these years the database has been used for assessing blowout risk associated to development and operation of fields offshore Norway. Six oil companies and two consultants are presently sponsoring the database. These companies are using the database when performing risk analyses. During the past three years the database has been subjected to a thorough quality improvement, both with respect to the user interface, and most important, regarding the blowout data included in the database. What is unique with this database, besides the high quality of blowout descriptions, is first that the blowout causes are categorized related to loss of primary and secondary barriers. Secondly that the user interface makes it possible to establish searches to withdraw information regarding any blowout type subjected for specific searches.

  16. Posttraumatic Orbital Emphysema: A Numerical Model

    PubMed Central

    Skorek, Andrzej; Kłosowski, Paweł; Plichta, Łukasz; Zmuda Trzebiatowski, Marcin; Lemski, Paweł

    2014-01-01

    Orbital emphysema is a common symptom accompanying orbital fracture. The pathomechanism is still not recognized and the usually assumed cause, elevated pressure in the upper airways connected with sneezing or coughing, does not always contribute to the occurrence of this type of fracture. Observations based on the finite model (simulating blowout type fracture) of the deformations of the inferior orbital wall after a strike in its lower rim. Authors created a computer numeric model of the orbit with specified features—thickness and resilience modulus. During simulation an evenly spread 14400 N force was applied to the nodular points in the inferior rim (the maximal value not causing cracking of the outer rim, but only ruptures in the inferior wall). The observation was made from 1 · 10−3 to 1 · 10−2 second after a strike. Right after a strike dislocations of the inferior orbital wall toward the maxillary sinus were observed. Afterwards a retrograde wave of the dislocation of the inferior wall toward the orbit was noticed. Overall dislocation amplitude reached about 6 mm. Based on a numeric model of the orbit submitted to a strike in the inferior wall an existence of a retrograde shock wave causing orbital emphysema has been found. PMID:25309749

  17. Posttraumatic orbital emphysema: a numerical model.

    PubMed

    Skorek, Andrzej; Kłosowski, Paweł; Plichta, Lukasz; Raczyńska, Dorota; Zmuda Trzebiatowski, Marcin; Lemski, Paweł

    2014-01-01

    Orbital emphysema is a common symptom accompanying orbital fracture. The pathomechanism is still not recognized and the usually assumed cause, elevated pressure in the upper airways connected with sneezing or coughing, does not always contribute to the occurrence of this type of fracture. Observations based on the finite model (simulating blowout type fracture) of the deformations of the inferior orbital wall after a strike in its lower rim. Authors created a computer numeric model of the orbit with specified features-thickness and resilience modulus. During simulation an evenly spread 14400 N force was applied to the nodular points in the inferior rim (the maximal value not causing cracking of the outer rim, but only ruptures in the inferior wall). The observation was made from 1 · 10(-3) to 1 · 10(-2) second after a strike. Right after a strike dislocations of the inferior orbital wall toward the maxillary sinus were observed. Afterwards a retrograde wave of the dislocation of the inferior wall toward the orbit was noticed. Overall dislocation amplitude reached about 6 mm. Based on a numeric model of the orbit submitted to a strike in the inferior wall an existence of a retrograde shock wave causing orbital emphysema has been found. PMID:25309749

  18. Patient specific implants (PSI) in reconstruction of orbital floor and wall fractures.

    PubMed

    Gander, Thomas; Essig, Harald; Metzler, Philipp; Lindhorst, Daniel; Dubois, Leander; Rücker, Martin; Schumann, Paul

    2015-01-01

    Fractures of the orbital wall and floor can be challenging due to the demanding three-dimensional anatomy and limited intraoperative overview. Misfitting implants and inaccurate surgical technique may lead to visual disturbance and unaesthetic results. A new approach using individually manufactured titanium implants (KLS Martin, Group, Germany) for daily routine is presented in the current paper. Preoperative CT-scan data were processed in iPlan 3.0.5 (Brainlab, Feldkirchen, Germany) to generate a 3D-reconstruction of the affected orbit using the mirrored non-affected orbit as template and the extent of the patient specific implant (PSI) was outlined and three landmarks were positioned on the planned implant in order to allow easy control of the implant's position by intraoperative navigation. Superimposition allows the comparison of the postoperative result with the preoperative planning. Neither reoperation was indicated due to malposition of the implant and the ocular bulb nor visual impairments could be assessed. PSI allows precise reconstruction of orbital fractures by using a complete digital workflow and should be considered superior to manually bent titanium mesh implants. PMID:25465486

  19. [Isolated medial orbital wall fracture and late fronto-ethmoidal mucocele].

    PubMed

    Iinuma, T; Hirota, Y; Kase, Y; Kuriyama, J; Yamane, M; Ichimura, K; Oyama, K

    1991-12-01

    Twenty-one cases of isolated medial orbital wall fractures were reported and CT findings by coronal planes were evaluated as to the effects of fractures upon the ethmoidal cells and nasal meati. Three coronal planes, which respectively contain such structures as Agger nasi, Pars membranacea and superior meatus, were selected for the study. The extent of fracture was evaluated by dividing the medial wall into three equal portions, i.e., superior, middle and inferior. The prolapsed volume was evaluated in three classes of occupying 1/3, 2/3 and 3/3 of the ethmoid. The presence of soft tissue density was recorded at the three surfaces, upper, medial and lower, around the prolapsed orbital content. The extent of the fracture was most often seen in such cases as involving all the three divisions in 41.3%. The prolapsed volume occupying 1/3 was seen in 28, 6%, and 2/3 in 23.8%. The presence of soft tissue density was seen in 38.1% of upper surface, in 36.5% of medial, and 11.1% of lower. Summarizing the total effects of the fractures, the coronal plane containing Pars membranacea was most severely damaged followed by the plane of the superior meatus. Two rare cases of fronto-ethmoidal mucoceles, caused by the traumas of 23 and 14 years before respectively, were also included and reported. The ophthalmological prognosis was favorable in 90.5% of cases by observations extending more than 6 months. Five cases were surgically treated including two cases of mucoceles.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:1779265

  20. Influence of kinesiologic tape on postoperative swelling, pain and trismus after zygomatico-orbital fractures.

    PubMed

    Ristow, Oliver; Pautke, Christoph; Victoria Kehl; Koerdt, Steffen; Schwärzler, Katharina; Hahnefeld, Lilian; Hohlweg-Majert, Bettina

    2014-07-01

    Surgical treatment of zygomatico-orbital (ZO) fractures is a common procedure in maxillofacial surgery. Often accompanied by pain, trismus and swelling, postoperative morbidity is a major disadvantage, affecting patients' quality of life. The appliance of kinesiologic tape (KT) improves the blood and lymph flow, removing congestions of lymphatic fluid and haemorrhages. The aim of this study was to find out if the application of kinesiologic tape prevents or improves swelling, pain and trismus after zygomatico-orbital fracture surgery, improving patients' postoperative quality of life. A total of 30 patients were assigned for treatment of zygomatico-orbital fractures and were randomly divided into treatment either with or without kinesiologic tape. Tape was applied directly after surgery and maintained for at least 5 days postoperatively. Facial swelling was quantified using a five-line measurement at six specific time points. Pain and degree of mouth opening was measured. Patient's subjective feeling and satisfaction was queried. The results of this study show that application of kinesiologic tape after zygomatico-orbital surgery significantly reduced the incidence of swelling with an earlier swelling maximum, and decreased the maximum turgidity for more than 60% during the first 2 days after surgery. Although, kinesiologic tape has no significant influence on pain control and trismus, mouth opening increased earlier after operation in the kinesiologic tape group compared to the no-kinesiologic tape group. Furthermore, patients with kinesiologic tape felt significantly lower morbidity than those without kinesiologic tape. Therefore kinesiologic tape is a promising, simple, less traumatic, economical approach, which is free from adverse reaction and improves patients' quality of life. PMID:23830769

  1. Orbital roof fracture and orbital cellulitis secondary to halo pin penetration: case report.

    PubMed

    Menon, K Venugopal; Al Rawi, Asif Esam; Taif, Sawsan; Al Ghafri, Khalifa; Mollahalli, Kishore Kumar

    2015-02-01

    Study Design Case report. Objective To report and discuss a rare complication after a patient was treated conservatively with a halo vest. Methods A 51-year-old man sustained a hangman's injury of the C2 vertebra following a motor vehicle collision. He was treated conservatively in a halo vest appliance and following mobilization was discharged from the hospital. Two weeks after discharge, the patient presented to the emergency department complaining of proptosis, ptosis, diplopia, and pin loosening. He was readmitted to the hospital, the halo vest was removed, and urgent imaging studies including computed tomography scan and magnetic resonance imaging were performed. They revealed that one of the halo pins had penetrated the orbital roof with active infection of the extraocular soft tissues. In consultation with the ophthalmologist, he was treated conservatively with antibiotics for 10 days. Results His ophthalmologic complaints resolved gradually and his eye returned to normal appearance and function. In the meantime, he was immobilized in a sterno-occipital mandibular immobilizer brace. Conclusion Though rare, penetrating injuries after cranial pin insertion can occur. Halo devices must be applied by, or under close supervision of, experienced personnel to avoid such complications, and halo vests should be reviewed frequently to detect such incidents early. PMID:25648519

  2. Epistaxis as the only initial symptom in pediatric naso-orbital-ethmoid fracture complicated with meningitis.

    PubMed

    Chou, Erh-Kang; Wu, Chao-I; Yu, Jack Chung-Kai; Chang, Sophia Chia-Ning

    2009-05-01

    Epistaxis is a frequent finding in patients with facial trauma. Herein, we report an unusual presentation of pediatric naso-orbital-ethmoid (NOE) fracture with epistaxis as the only initial symptom. The course of the patient's condition was later complicated by meningitis, related in part to the delay in diagnosis. A 3-year-old girl with preexisting upper respiratory symptoms was involved in a traffic accident, sustaining blunt trauma to the right side of her face. During the initial examination, only right-sided epistaxis was noted. Five days later, she developed febrile convulsion and was admitted to the intensive care unit with other signs of meningitis such as mental status change and neck stiffness. Her craniofacial computed tomographic scan showed a right-sided NOE fracture with minimal displacement and without dura tear. The cerebrospinal fluid culture grew Streptococcus pneumoniae, which may be due to ascending infection as a result of cribriform plate fracture. Intravenous antibiotic therapy was initiated with good response, and she was discharged from the hospital after 2 weeks. The presence of epistaxis and periorbital bruise, together with other symptoms and signs, helps in the identification of NOE and cribriform plate fracture. A high index of suspicion with repetitive computed tomographic scans is necessary to achieve correct early diagnosis. Parental antibiotic therapy is indicated if ascending cerebrospinal fluid infection develops. PMID:19461340

  3. Maxillofacial Fractures: Midface and Internal Orbit-Part II: Principles and Surgical Treatment.

    PubMed

    Mast, Gerson; Ehrenfeld, Michael; Cornelius, Carl-Peter; Tasman, Abel-Jan; Litschel, Ralph

    2015-08-01

    Current clinical assessment and imaging techniques were described in part 1, and this article presents a systematic review of the surgical treatment principles in the management of midface and internal orbit fractures from initial care to definitive treatment, including illustrative case examples. New developments enabled limited surgical approaches by standardization of osteosynthesis principles regarding three-dimensional buttress reconstruction, by newly developed individualized implants such as titanium meshes and, especially for complex fracture patterns, by critical assessment of anatomical reconstruction through intraoperative endoscopy, as well as intra- and postoperative imaging. Resorbable soft tissue anchors can be used both for ligament and soft tissue resuspension to reduce ptosis effects in the cheeks and nasolabial area and to achieve facial aesthetics similar to those prior to the injury. PMID:26372710

  4. Paediatric Orbital Fractures: The Importance of Regular Thorough Eye Assessment and Appropriate Referral

    PubMed Central

    Kassam, Karim; Rahim, Ishrat; Mills, Caroline

    2013-01-01

    The paediatric orbital fracture should always raise alarm bells to all clinicians working in an emergency department. A delay or failure in diagnosis and appropriate referral can result in rapidly developing and profound complications. We present a boy of childhood age who sustained trauma to his eye during a bicycle injury. Acceptance of the referral was based on no eye signs; however, on examination in our unit the eye had reduction in visual acuity, no pupillary reaction, and ophthalmoplegia. CT scan suggested bone impinging on the globe and the child was rushed to theatre for removal of the bony fragment. Postoperatively no improvement was noted and a diagnosis of traumatic optic neuropathy was made. An overview of factors complicating paediatric orbital injuries, their associated “red flags”, and appropriate referral are discussed in this short paper. PMID:24349804

  5. Paediatric orbital fractures: the importance of regular thorough eye assessment and appropriate referral.

    PubMed

    Kassam, Karim; Rahim, Ishrat; Mills, Caroline

    2013-01-01

    The paediatric orbital fracture should always raise alarm bells to all clinicians working in an emergency department. A delay or failure in diagnosis and appropriate referral can result in rapidly developing and profound complications. We present a boy of childhood age who sustained trauma to his eye during a bicycle injury. Acceptance of the referral was based on no eye signs; however, on examination in our unit the eye had reduction in visual acuity, no pupillary reaction, and ophthalmoplegia. CT scan suggested bone impinging on the globe and the child was rushed to theatre for removal of the bony fragment. Postoperatively no improvement was noted and a diagnosis of traumatic optic neuropathy was made. An overview of factors complicating paediatric orbital injuries, their associated "red flags", and appropriate referral are discussed in this short paper. PMID:24349804

  6. Examination of Relationship Between Photonic Signatures and Fracture Strength of Fused Silica Used in Orbiter Windows

    NASA Technical Reports Server (NTRS)

    Yost, William T.; Cramer, K. Elliott; Estes, Linda R.; Salem, Jonathan A.; Lankford, James, Jr.; Lesniak, Jon

    2011-01-01

    A commercially available grey-field polariscope (GFP) instrument for photoelastic examination is used to assess impact damage inflicted upon the outermost pane of the orbiter windows. Four categories of damage: hyper-velocity impacts that occur during space-flight (HVI); hypervelocity impacts artificially made at the Hypervelocity Impact Technology Facility (HIT-F); impacts made by larger objects falling onto the pane surface to simulate dropped items on the window during service/storage of vehicle (Bruises); and light scratches from dull objects designed to mimic those that might occur by dragging a dull object across the glass surface (Chatter Checks) are examined. The damage sites are cored from fused silica window carcasses, examined with the GFP and other methodologies, and broken using the ASTM Standard C1499-09 to measure the fracture strength. A correlation is made between the fracture strength and damage-site measurements including geometrical measurements and GFP measurements of photoelastic retardation (stress patterns) surrounding the damage sites. An analytical damage model to predict fracture strength from photoelastic retardation measurements is presented and compared with experimental results.

  7. Infraorbital nerve transpositioning into orbital floor: a modified technique to minimize nerve injury following zygomaticomaxillary complex fractures

    PubMed Central

    Kotrashetti, Sharadindu Mahadevappa; Kale, Tejraj Pundalik; Bhandage, Supriya

    2015-01-01

    Objectives Transpositioning of the inferior alveolar nerve to prevent injury in lower jaw has been advocated for orthognathic, pre-prosthetic and for implant placement procedures. However, the concept of infra-orbital nerve repositioning in cases of mid-face fractures remains unexplored. The infraorbital nerve may be involved in trauma to the zygomatic complex which often results in sensory disturbance of the area innervated by it. Ten patients with infraorbital nerve entrapment were treated in similar way at our maxillofacial surgery centre. Materials and Methods In this article we are reporting three cases of zygomatico-maxillary complex fracture in which intra-operative repositioning of infra-orbital nerve into the orbital floor was done. This was done to release the nerve from fractured segments and to reduce the postoperative neural complications, to gain better access to fracture site and ease in plate fixation. This procedure also decompresses the nerve which releases it off the soft tissue entrapment caused due to trauma and the organized clot at the fractured site. Results There was no evidence of sensory disturbance during their three month follow-up in any of the patient. Conclusion Infraorbital nerve transposition is very effective in preventing paresthesia in patients which fracture line involving the infraorbital nerve. PMID:25922818

  8. Blowout control efforts continue off Louisiana

    SciTech Connect

    Not Available

    1992-10-12

    This paper reports that Greenhill Petroleum Corp., Houston, last week stepped up efforts to control a workover blowout in Timbalier Bay field off Lafourche Parish, La. The blowout occurred as Blake Drilling and Workover Co., Belle Chasse, La., was deepening the Gulf of Mexico well. Plans called for abandoning Miocene D-4 sand perforations at 8,683-86 ft and 8,696-8,706 ft and recompleting in Miocene D-6 sand at 8,802-28 ft.

  9. Lower Eyelid Malposition Following Orbital Fracture Surgery: A Retrospective Analysis Based on 198 Surgeries.

    PubMed

    Kesselring, Alexandra G; Promes, Paul; Strabbing, Elske M; van der Wal, Karel G H; Koudstaal, Maarten J

    2016-06-01

    The aim of this study is to analyze the development of lower eyelid malposition following reconstruction of orbital fractures, in relation to the incisions used for access. A total of 198 surgical orbital floor reconstructions were performed in 175 patients between 2001 and 2011. Preoperative and postoperative presence of lower eyelid malposition of patients was reported. The types of incision used for access were as follows: approach via laceration (4.5%), via preexisting scar (16.2%), infraorbital (40.9%), subciliar (23.7%), transconjunctival (13.1%), and transconjunctival with lateral canthotomy (1.5%). The incidence of ectropion development following surgery was 3.0% and the incidence of entropion development following surgery was 1.0%. The highest rate of ectropion (11.1%) was seen using an approach via a laceration, followed by approach via a scar (6.3%). Our conclusion is that the transconjunctival incision without a lateral canthotomy has a low complication rate, provides adequate exposure, and leaves no visible scar. PMID:27162565

  10. Penetrating injury of orbital roof and brain sparing the eye ball in a pediatric patient: A rare occurrence.

    PubMed

    Kumar, Vikul; Singh, Atul Kumar; Bhaikhel, Kulwant Singh

    2016-01-01

    Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from the left eye which suggested tear of dura mater. Urgent left frontal craniotomy was done with the evacuation of contusion, reconstruction of orbital roof, and duroplasty under general anesthesia. PMID:27606024

  11. Penetrating injury of orbital roof and brain sparing the eye ball in a pediatric patient: A rare occurrence

    PubMed Central

    Kumar, Vikul; Singh, Atul Kumar; Bhaikhel, Kulwant Singh

    2016-01-01

    Blowout fractures are a common occurrence in traumatic brain injury patients. In pediatric age group, orbital floor fracture is a common occurrence. We report a case of 2-year-old male admitted to trauma center, with penetrating injury to the left eye by the clutch of motorbike which fell on the child. Noncontrast computed tomography scan revealed fracture of the roof of left orbit with left frontal contusion sparing the left eyeball. There was also the continuous leak of brain matter from the left eye which suggested tear of dura mater. Urgent left frontal craniotomy was done with the evacuation of contusion, reconstruction of orbital roof, and duroplasty under general anesthesia. PMID:27606024

  12. Predictive value of visual evoked potentials, relative afferent pupillary defect, and orbital fractures in patients with traumatic optic neuropathy

    PubMed Central

    Tabatabaei, Seyed Ali; Soleimani, Mohammad; Alizadeh, Mahdi; Movasat, Morteza; Mansoori, Mohammad Reza; Alami, Zakieh; Foroutan, Alireza; Joshaghani, Mahmood; Safari, Saeid; Goldiz, Arzhang

    2011-01-01

    Background: The purpose of this study was to determine the predictive value of flash visual-evoked potentials (VEP), relative afferent pupillary defect, and presence of orbital fractures in patients with traumatic optic neuropathy. Methods: A prospective study was conducted in 15 patients with indirect traumatic optic neuropathy. All patients underwent a thorough ophthalmic examination. Initial visual acuity, final visual acuity, and relative afferent pupillary defect were determined, and visual acuity was converted into logMAR units. We performed flash VEP and an orbital computed tomography scan in all patients. Results: There was a good correlation between relative afferent pupillary defect and final visual acuity (r = −0.83), and better initial visual acuity could predict better final visual acuity (r = 0.92). According to findings from flash VEP parameters, there was a relationship between final visual acuity and amplitude ratio of the wave (r = 0.59) and latency ratio of the wave (r = −0.61). Neither primary visual acuity nor final visual acuity was related to the presence of orbital fractures in the orbital CT scan. Conclusion: Patients with traumatic optic neuropathy often present with severe vision loss. Flash VEP, poor initial visual acuity, and higher grade of relative afferent pupillary defect could predict final visual acuity in these patients. Presence of orbital fracture was not a predictive factor for primary visual acuity or final visual acuity. PMID:21845028

  13. PHYSICAL PARAMETERS OF STANDARD AND BLOWOUT JETS

    SciTech Connect

    Pucci, Stefano; Romoli, Marco; Poletto, Giannina; Sterling, Alphonse C.

    2013-10-10

    The X-ray Telescope on board the Hinode mission revealed the occurrence, in polar coronal holes, of much more numerous jets than previously indicated by the Yohkoh/Soft X-ray Telescope. These plasma ejections can be of two types, depending on whether they fit the standard reconnection scenario for coronal jets or if they include a blowout-like eruption. In this work, we analyze two jets, one standard and one blowout, that have been observed by the Hinode and STEREO experiments. We aim to infer differences in the physical parameters that correspond to the different morphologies of the events. To this end, we adopt spectroscopic techniques and determine the profiles of the plasma temperature, density, and outflow speed versus time and position along the jets. The blowout jet has a higher outflow speed, a marginally higher temperature, and is rooted in a stronger magnetic field region than the standard event. Our data provide evidence for recursively occurring reconnection episodes within both the standard and the blowout jet, pointing either to bursty reconnection or to reconnection occurring at different locations over the jet lifetimes. We make a crude estimate of the energy budget of the two jets and show how energy is partitioned among different forms. Also, we show that the magnetic energy that feeds the blowout jet is a factor of 10 higher than the magnetic energy that fuels the standard event.

  14. Blow-in fracture of the orbital roof presenting as a case of non-resolving choroidal effusion.

    PubMed

    Mukherjee, Bipasha; Bhende, Muna

    2010-01-01

    A 34-year-old male patient was referred to us as a case of non-resolving suprachoroidal hemorrhage. History revealed decrease in right eye vision following trauma to forehead. B scan ultrasonography (USG) of the right eye showed a high-reflective structure indenting the globe. It turned out to be an inferiorly displaced fracture fragment from the orbital roof on computerized tomography (CT) scan. The choroidal elevation disappeared after open reduction of the fracture fragment and patient had good recovery of vision. USG and CT scan were helpful in the diagnosis and management of this case. PMID:20534928

  15. Isolated inferior rectus muscle rupture after blunt orbital trauma

    PubMed Central

    Tomasetti, Patrick; Metzler, Philipp; Jacobsen, Christine

    2013-01-01

    A 44-year-old man was referred to our department with diplopia, periorbital swelling and haematoma of the left eye after orbital trauma due to a punch. During the examination, mild enophthalmos, hypertropia and a total absence of infraduction were observed. An orbital computed tomography (CT) scan demonstrated a left orbital floor blow-out fracture, with caudal herniation of periorbital fat and rectus inferior muscle. Repair was performed under total anaesthesia with placement of a Titan mesh. The following days were marked by the persistence of diplopia without improvement of infraduction. A postoperative, 0.5 mm CT scan highlighted a complete rupture of the inferior rectus muscle, not seen before operation, by a 1.0 mm-sliced CT. In this case, orthoptic therapy was undertaken with good results after 6 months and without need of a second repair. PMID:24963904

  16. Systems and methods for detection of blowout precursors in combustors

    DOEpatents

    Lieuwen, Tim C.; Nair, Suraj

    2006-08-15

    The present invention comprises systems and methods for detecting flame blowout precursors in combustors. The blowout precursor detection system comprises a combustor, a pressure measuring device, and blowout precursor detection unit. A combustion controller may also be used to control combustor parameters. The methods of the present invention comprise receiving pressure data measured by an acoustic pressure measuring device, performing one or a combination of spectral analysis, statistical analysis, and wavelet analysis on received pressure data, and determining the existence of a blowout precursor based on such analyses. The spectral analysis, statistical analysis, and wavelet analysis further comprise their respective sub-methods to determine the existence of blowout precursors.

  17. Epithelial cysts associated with alloplastic implants after repair of orbital fractures: a systematic review and four new cases.

    PubMed

    Su, Yun; Sun, Jing; Fan, Xianqun

    2016-07-01

    An epithelial cyst is a rare and often late complication of long-term alloplastic implants, which has the potential to lead to further complications and harm to patients. We made a systematic review of papers published during the past 30 years about the mechanisms and clinical characteristics formation of epithelial cysts after repair of an orbital fracture by searching PubMed, Medline, and Web of Science to collect all related case reports and series published in the English language. We also made a retrospective review of casenotes of all patients diagnosed with orbital epithelial cysts in our department. We found 19 cases of epithelial cysts, including the four cases of our own, associated with alloplastic material, 12 of which were associated with silicone. There were 12 men and seven women aged from 26-71 years old. Orbital cysts developed 15 months-31 (median 8) years after implantation. Histological analysis confirmed that the cysts were all epithelial cysts lined with squamous or respiratory (or both) cells, and differing degrees of chronic inflammation. Epithelial cysts after implantation of alloplastic material may present with various symptoms several years after repair of orbital fractures, and their formation probably results from the synergistic effects of both ectopic cells and chronic inflammation. The implant itself may be a trigger, and the cysts did not seem to be limited to one specific type of implant. PMID:27094498

  18. Blowout regimes of plasma wakefield acceleration.

    PubMed

    Lotov, K V

    2004-04-01

    A wide region of beam parameters is numerically scanned and the dependence of wakefield properties on the beam length and current is clarified for the blowout regime of beam-plasma interaction. The main regimes of the plasma response are found, which qualitatively differ in the plasma behavior. To characterize the efficiency of the energy exchange between the beam and the plasma, the energy flux through the comoving window is introduced. Scalings of the energy flux for the linear plasma response and the main blowout regimes are studied. The most efficient energy transfer occurs in the so-called "strong beam" regime of interaction. For this regime, analytical approximations for various aspects of the plasma response are obtained. PMID:15169104

  19. Maxillofacial fractures in the province of Latina, Lazio, Italy: review of 400 injuries and 83 cases.

    PubMed

    Arangio, Paolo; Vellone, Valentino; Torre, Umberto; Calafati, Vincenzo; Capriotti, Marco; Cascone, Piero

    2014-07-01

    A retrospective study was performed to assess maxillofacial fractures in patients treated at the public "S.M. Goretti Hospital" hospital from 2011 to 31/8/2012. Data were prospectively recorded including age and sex, cause and mechanisms of injury, soft tissue injuries, dentoalveolar trauma, facial bone fractures and type of treatment. The pre-surgical and post-surgical hospitalization days were also analysed. Causes were grouped into five categories: road traffic collision, sports accidents, occupational accidents, assaults and domestic accidents. The analyses involved descriptive statistics. Records from 83 patient sustaining 95 maxillofacial fractures were evaluated. The zygoma was the most fractured anatomical site in both males and females, accounting for 32% of injuries, followed by isolated fracture of the orbital floor (blow-out and blow-in) with 11%. The age group between 18 and 39 years showed the highest rate of incidence of maxillofacial fractures. Men were more involved than women in all cases with a male:female ratio of 5,4:1. Accidents were the most frequent cause of maxillofacial fractures in the age group between 18 and 39 years and interpersonal violence was the most frequent cause of maxillofacial fractures in the age group between 40 and 59 years. Facial fractures occurred primarily among men under 30 years of age, and the most common sites of fractures in the face were the mandible and the zygomatic complex. Road traffic collisions were the main aetiologic factor associated with maxillofacial trauma. PMID:24035287

  20. Fractures

    PubMed Central

    Hall, Michael C.

    1963-01-01

    Recent studies on the epidemiology and repair of fractures are reviewed. The type and severity of the fracture bears a relation to the age, sex and occupation of the patient. Bone tissue after fracture shows a process of inflammation and repair common to all members of the connective tissue family, but it repairs with specific tissue. Cartilage forms when the oxygen supply is outgrown. After a fracture, the vascular bed enlarges. The major blood supply to healing tissue is from medullary vessels and destruction of them will cause necrosis of the inner two-thirds of the cortex. Callus rapidly mineralizes, but full mineralization is achieved slowly; increased mineral metabolism lasts several years after fracture. PMID:13952119

  1. 16 CFR 1507.6 - Burnout and blowout.

    Code of Federal Regulations, 2011 CFR

    2011-01-01

    ... 16 Commercial Practices 2 2011-01-01 2011-01-01 false Burnout and blowout. 1507.6 Section 1507.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS FIREWORKS DEVICES § 1507.6 Burnout and blowout. The pyrotechnic chamber in fireworks devices shall...

  2. 16 CFR 1507.6 - Burnout and blowout.

    Code of Federal Regulations, 2010 CFR

    2010-01-01

    ... 16 Commercial Practices 2 2010-01-01 2010-01-01 false Burnout and blowout. 1507.6 Section 1507.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS FIREWORKS DEVICES § 1507.6 Burnout and blowout. The pyrotechnic chamber in fireworks devices shall...

  3. 16 CFR 1507.6 - Burnout and blowout.

    Code of Federal Regulations, 2012 CFR

    2012-01-01

    ... 16 Commercial Practices 2 2012-01-01 2012-01-01 false Burnout and blowout. 1507.6 Section 1507.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS FIREWORKS DEVICES § 1507.6 Burnout and blowout. The pyrotechnic chamber in fireworks devices shall...

  4. 16 CFR 1507.6 - Burnout and blowout.

    Code of Federal Regulations, 2013 CFR

    2013-01-01

    ... 16 Commercial Practices 2 2013-01-01 2013-01-01 false Burnout and blowout. 1507.6 Section 1507.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS FIREWORKS DEVICES § 1507.6 Burnout and blowout. The pyrotechnic chamber in fireworks devices shall...

  5. 16 CFR 1507.6 - Burnout and blowout.

    Code of Federal Regulations, 2014 CFR

    2014-01-01

    ... 16 Commercial Practices 2 2014-01-01 2014-01-01 false Burnout and blowout. 1507.6 Section 1507.6 Commercial Practices CONSUMER PRODUCT SAFETY COMMISSION FEDERAL HAZARDOUS SUBSTANCES ACT REGULATIONS FIREWORKS DEVICES § 1507.6 Burnout and blowout. The pyrotechnic chamber in fireworks devices shall...

  6. Orbital Fracture Leading to Severe Multifascial Space Infection Including the Parapharyngeal Space: A Report of a Case and Review of the Literature

    PubMed Central

    Park, Chan; Marchiori, Erica; Barber, Jacob; Cardon, Curtis

    2014-01-01

    Orbital trauma can result in periorbital and orbital infections. Orbital infections have been classified by Chandler et al in 1970 to their anatomic location and boundaries. This case report describes a patient who developed a severe orbital infection following orbital fractures. The infection progressed to the parapharyngeal space. The patient required multiple incision and drainage surgeries and tissue debridements to have clinical resolution. To our knowledge, there has not been a case described in the literature of an orbital infection progressing to the parapharyngeal space. A literature review of orbital trauma leading to infection discusses the pathogenesis of the infections. This case demonstrates that close clinical follow-up and appropriate medical management of comorbidities that put a patient at higher risk of developing an infection is of the utmost importance in the treatment of maxillofacial trauma patients. PMID:25136414

  7. Fractures

    MedlinePlus

    ... commonly happen because of car accidents, falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the bones. Overuse can cause stress fractures, which are very small cracks in the ...

  8. Fractures

    MedlinePlus

    A fracture is a break, usually in a bone. If the broken bone punctures the skin, it is called an open ... falls, or sports injuries. Other causes are low bone density and osteoporosis, which cause weakening of the ...

  9. Posterior Wall Blowout in Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Mitchell, Justin J.; Dean, Chase S.; Chahla, Jorge; Menge, Travis J.; Cram, Tyler R.; LaPrade, Robert F.

    2016-01-01

    Violation of the posterior femoral cortex, commonly referred to as posterior wall blowout, can be a devastating intraoperative complication in anterior cruciate ligament (ACL) reconstruction and lead to loss of graft fixation or early graft failure. If cortical blowout occurs despite careful planning and adherence to proper surgical technique, a thorough knowledge of the anatomy and alternative fixation techniques is imperative to ensure optimal patient outcomes. This article highlights anatomic considerations for femoral tunnel placement in ACL reconstruction and techniques for avoidance and salvage of a posterior wall blowout. PMID:27335885

  10. Three-Dimensional Pre-Bent Titanium Implant for Concomitant Orbital Floor and Medial Wall Fractures in an East Asian Population

    PubMed Central

    Lee, Kyung Min; Park, Ji Ung; Kwon, Sung Tack; Kim, Suk Wha

    2014-01-01

    Background The objective of this article is to evaluate clinical outcomes of combined orbital floor and medial wall fracture repair using a three-dimensional pre-bent titanium implant in an East Asian population. Methods Clinical and radiologic data were analyzed for 11 patients with concomitant orbital floor and medial wall fractures. A combined transcaruncular and inferior fornix approach with lateral canthotomy was used for the exposure of fractures. An appropriate three-dimensional preformed titanium implant was selected and inserted according to the characteristics of a given defect. Results Follow-up time ranged from 2 to 6 months (median, 4.07 months). All patients had a successful treatment outcome without any complications. Clinically significant enophthalmos was not observed after treatment. Conclusions Three-dimensional pre-bent titanium implants are appropriate for use in the East Asian population, with a high success rate of anatomic restoration of the orbital volume and prevention of enophthalmos in combined orbital floor and medial wall fracture cases. PMID:25276638

  11. Two-Year Follow-up on the Use of Absorbable Mesh Plates in the Treatment of Medial Orbital Wall Fractures

    PubMed Central

    You, Jae-Pil; Kim, Deok-Woo; Jeon, Byung-Joon; Jeong, Seong-Ho; Han, Seung-Kyu; Kim, Woo-Kyung

    2013-01-01

    Background Absorbable materials offer many advantages in the reconstruction of orbital walls; however, the possibility of postoperative enophthalmos after complete absorption cannot be excluded. We evaluated the postoperative results of absorbable mesh plates used as onlay implanting on the medial orbital wall to determine whether they are suitable for medial orbital wall reconstruction. Methods The study included 20 patients with medial orbital wall fractures who were followed up for more than 2 years postoperatively. We used absorbable mesh plates in all of the patients. We measured the following: the changes in the expanded orbital volume by comparing the preoperative and postoperative computed tomography (CT) scans and the degree of clinical enophthalmos. Results There were no major complications associated with the use of absorbable materials such as infection, migration, or extrusion of mesh plates during the long-term follow-up. The orbital volumetric changes between the preoperative and postoperative CT scans were not statistically significant. However, the expanded orbital volume was not related to the degree of clinical enophthalmos. Conclusions The reconstructed orbital wall may provide supportive scar tissue to the orbital contents even after the absorbable materials have dissolved completely. Absorbable mesh plates could be another option for the reconstruction of the medial orbital wall. PMID:24286046

  12. Late migration of an orbital implant causing orbital hemorrhage with sudden proptosis and diplopia.

    PubMed

    Rosen, C E

    1996-12-01

    A 31-year-old woman complained of sudden diplopia and proptosis associated with a headache. Approximately 10 years earlier, she had sustained a right orbital blowout fracture during a snow machine accident that was repaired using a Supramid implant. She presented with 4 mm of right-sided proptosis by Hertel exophthalmometry, with limitation of up and down gaze. She manifested a right gaze preference with a left head turn to achieve fusion. Visual acuity was 20/20 on both sides; however, there was 20% red desaturation and a subtle afferent pupillary defect on the right side. Goldmann visual fields were full and the retinal examination was normal. A computed tomography (CT) scan of the orbits with and without contrast demonstrated a large right posterior inferior orbital mass. Once the periorbita was breached during orbitotomy, a burgundy serosanguinous material emerged. Gram staining revealed red cells without organisms. The implant had not been fixed by wires or screws. Upon removal, the implant appeared oversized, encompassing the orbital floor, medial and lateral walls. Postoperatively, the proptosis, gaze preference with face turn, afferent pupillary defect, desaturation abnormality, and diplopia resolved. PMID:8944386

  13. Modelling turbulent flame ignition and blowout

    NASA Technical Reports Server (NTRS)

    Radhakrishnan, K.; Heywood, J. B.

    1979-01-01

    A statistical mixing model incorporating an overall rate equation to describe the fuel oxidation process was developed for studies of ignition and blowout in a combustor primary zone. This zone is treated as a partially stirred reactor whose composition is described by a statistical ensemble of equal mass fluid elements. This ensemble experiences mixing interactions, which represent the turbulent mixing process, at time intervals governed by an empirically determined mixing frequency. Each mixing interaction is computed by ramdomly selecting two different elements which are then allowed to mix completely so that they reach a mean composition depending on their thermodynamic states prior to mixing. The two elements then separate, and the chemical kinetics proceed depending on their new composition and temperature.

  14. Momentum kill procedure can quickly control blowouts

    SciTech Connect

    Watson, W.D. ); Moore, P. )

    1993-08-30

    The momentum kill method can help in quickly regaining control of a blowing well, providing the blowing well rate and fluid properties can be estimated reasonably. The momentum of the kill fluid counteracts and overcomes the flowing momentum of formation fluids. In other words, sufficient mud density pumped at a sufficient rate is directed into the flow stream to force the escaping fluid column back into the well bore. Sufficient kill fluid hydrostatic pressure must be stacked'' in the hole so that the well remains dead after the operation. The momentum kill is not a panacea for all blowouts. An assessment must be made of the potential problems unique to this method, and certain requirements must be met if the technique is to be successful. The paper discusses some of the considerations for evaluating the use of the momentum kill method.

  15. Combined Orbital Floor and Medial Wall Fractures Involving the Inferomedial Strut: Repair Technique and Case Series Using Preshaped Porous Polyethylene/Titanium Implants

    PubMed Central

    Cho, Raymond I.; Davies, Brett W.

    2013-01-01

    Background Combined orbital floor and medial wall fractures can be technically challenging to repair, particularly when the inferomedial strut is involved. A surgical repair technique is described utilizing a single preshaped porous polyethylene/titanium implant to span both defects. Methods Retrospective interventional case series. Results Fracture repair was performed on 17 orbits (16 patients) between October 2009 and February 2012. Subsequent surgical revision was required in three cases (18%). Visual acuity was stable or improved in all cases. Of 7 patients with preoperative diplopia, 5 improved and 2 remained stable postoperatively, and there were no cases of new or worsened diplopia following surgery. Postoperative asymmetry in Hertel exophthalmometry averaged 1.0 mm (range 0 to 2 mm). Preoperatively, average orbital volume was 122.7% compared with control (range 109 to 147%, standard deviation [SD] 9.6), which improved to 100.3% postoperatively (range 92 to 110%, SD 5.7). The average decrease in orbital volume was 22.5% (range 10 to 54%, SD 11.4, p < 0.001). Conclusions With careful preoperative planning and meticulous surgical technique, combined orbital floor and medial wall fractures involving the inferomedial strut can be successfully repaired with a preshaped porous polyethylene/titanium implant through a transconjunctival/transcaruncular approach with inferior oblique disinsertion. PMID:24436754

  16. Determination of blowout pressures during electron beam welding

    SciTech Connect

    Sunwoo, A

    1999-04-01

    During electron beam (EB) welding of developmental units, weld blowouts occurred. It is well documented that the presence of moisture causes the weld blowout. The detrimental effects of water vapor on the weld are experimentally proven [l]. The availability of water vapor in the melt increases the onset and severity of blowout and porosity. Because water vapor is insoluble in the molten metal, it will consequently form either bubbles or boil. On the other hand, hydrogen will react with other impurities present in the melt to form insoluble gas bubbles, which most likely will be entrapped in the fusion zone as porosity. This study attempts to answer the question of what is the critical weld blowout pressure, and to compare the experimental results to the estimated pressure values, so that validated calculations could be extended to other weld configurations.

  17. Fluid dynamics used to kill South Louisiana blowout

    SciTech Connect

    Grace, R.D.; Cudd, B.

    1989-04-01

    Blowouts often result in severe damage to downhole tubulars and surface equipment. The damage is routinely so extensive that reliance on tubular integrity only results in further loss of control. In some cases, the damaged equipment may appear to be in good condition only to be found inadequate in time of need. Under these situations, fluid dynamics have proven invaluable in regaining control of the well. In many instances, well control is relegated to the realm of the mystic. The authors can engineer men to the moon, but their only solution to a blowout is a bigger stick. According to many, well control and blowouts are exempt from obeying the laws of science. Experience has shown that blowouts are engineering problems subject to the same physical laws as all engineering problems and more can be gained by working within these laws than by relying on fear and superstition.

  18. DICHOTOMY OF SOLAR CORONAL JETS: STANDARD JETS AND BLOWOUT JETS

    SciTech Connect

    Moore, Ronald L.; Cirtain, Jonathan W.; Sterling, Alphonse C.; Falconer, David A.

    2010-09-01

    By examining many X-ray jets in Hinode/X-Ray Telescope coronal X-ray movies of the polar coronal holes, we found that there is a dichotomy of polar X-ray jets. About two thirds fit the standard reconnection picture for coronal jets, and about one third are another type. We present observations indicating that the non-standard jets are counterparts of erupting-loop H{alpha} macrospicules, jets in which the jet-base magnetic arch undergoes a miniature version of the blowout eruptions that produce major coronal mass ejections. From the coronal X-ray movies we present in detail two typical standard X-ray jets and two typical blowout X-ray jets that were also caught in He II 304 A snapshots from STEREO/EUVI. The distinguishing features of blowout X-ray jets are (1) X-ray brightening inside the base arch in addition to the outside bright point that standard jets have, (2) blowout eruption of the base arch's core field, often carrying a filament of cool (T {approx} 10{sup 4} - 10{sup 5} K) plasma, and (3) an extra jet-spire strand rooted close to the bright point. We present cartoons showing how reconnection during blowout eruption of the base arch could produce the observed features of blowout X-ray jets. We infer that (1) the standard-jet/blowout-jet dichotomy of coronal jets results from the dichotomy of base arches that do not have and base arches that do have enough shear and twist to erupt open, and (2) there is a large class of spicules that are standard jets and a comparably large class of spicules that are blowout jets.

  19. Dichotomy of Solar Coronal Jets: Standard Jets and Blowout Jets

    NASA Technical Reports Server (NTRS)

    Moore, R. L.; Cirtain, J. W.; Sterling, A. C.; Falconer, D. A.

    2010-01-01

    By examining many X-ray jets in Hinode/XRT coronal X-ray movies of the polar coronal holes, we found that there is a dichotomy of polar X-ray jets. About two thirds fit the standard reconnection picture for coronal jets, and about one third are another type. We present observations indicating that the non-standard jets are counterparts of erupting-loop H alpha macrospicules, jets in which the jet-base magnetic arch undergoes a miniature version of the blowout eruptions that produce major CMEs. From the coronal X-ray movies we present in detail two typical standard X-ray jets and two typical blowout X-ray jets that were also caught in He II 304 Angstrom snapshots from STEREO/EUVI. The distinguishing features of blowout X-ray jets are (1) X-ray brightening inside the base arch in addition to the outside bright point that standard jets have, (2) blowout eruption of the base arch's core field, often carrying a filament of cool (T 10(exp 4) - 10(exp 5) K) plasma, and (3) an extra jet-spire strand rooted close to the bright point. We present cartoons showing how reconnection during blowout eruption of the base arch could produce the observed features of blowout X-ray jets. We infer that (1) the standard-jet/blowout-jet dichotomy of coronal jets results from the dichotomy of base arches that do not have and base arches that do have enough shear and twist to erupt open, and (2) there is a large class of spicules that are standard jets and a comparably large class of spicules that are blowout jets.

  20. Failure Analysis of Fractured Poppet from Space Shuttle Orbiter Flow Control Valve

    NASA Technical Reports Server (NTRS)

    Russell, Richard

    2010-01-01

    This slide presentation reviews the failure analysis of a fractured poppet from a flow control valve (FCV) used on the space shuttle. This presentation has focused on the laboratory analysis of the failed hardware. The use of Scanning electron fractography during the investigation led to the conclusion that the poppet failed due to fatigue cracking that, most likely, occurred under changing loading conditions. The initial investigation led to a more thorough test of poppets that had been retired, this testing led to the conclusion that the thumbnail cracks in the flight hardware had existed for the life of the shuttle program. This led to a program to develop an eddy current technique that was capable of detecting small very tight cracks.

  1. A Retrospective Audit of Hundred Patients of Orbitozygomatic Fractures with Brain Injury

    PubMed Central

    Gulzar, Gupta; Sanjeev, Uppal; Rajinder, Mittal; Ranabir, Pal; Nikhil, Garg

    2014-01-01

    Background: Orbitozygomatic fracture that most commonly accompanies craniofacial injury is a challenge for medical science to reduce complications and to attain aesthetically satisfying results. Objective: To summarize our experiences with the optimum management of orbito-zygomatic fractures. Materials and Methods: This retrospective study was aimed at investigating indications and surgical approaches for orbitozygomatic fractures with clinical follow-up, particularly with regard to postoperative complications. Since 2010, 100 cases with faciomaxillary injury were assessed for Orbitozygomatic fractures with the help of physical examination, non-invasive investigations including computed tomography of the orbit. Patients were retrospectively analysed for data, such as mechanism of injury, classification of fracture, and complications. Results: Amongst 100 consecutive patients with orbito-zygomatic fractures an overwhelming majority were males (n=83). In the age distribution a great majority (45%) were in 30-45 years age group, followed by 15-30 years (22%) and 45-60 years (18%). So in the productive age group i.e. 15-60 years age group were affected mostly (85%) in our series. Among different injury mechanism, Road traffic accident affected most (69%) that landed up in orbito-zygomatic fractures followed by altercations (22%). We preferred Open reduction and internal fixation (ORIF) for 68% of the patients with orbito- zygomatic fractures, followed by closed reduction (12%). Conclusion: Ophthalmology consultation is recommended for all patients presenting with orbitozygomatic fractures, and is essential for patients with orbital blowout fractures, based on the high incidence of clinical ocular findings and injuries in this subgroup of patients. PMID:25177598

  2. Blowout probe traces chain of events

    SciTech Connect

    LeBlanc, L.

    1980-12-01

    On March 5, 1980, the crew of Placid Oil's Platform C in South Marsh Island Block 281 was evacuated, culminating an attempt to stem a gas surge into a development well being drilled. Eight of the 35-member crew never made it. The USCG concluded: natural gas flowed up the drill pipe and into the strainer cross on the mud pump, where it blew out the gate valve on the pump recirculation line to the mud pits and forced the relief valve line to part, renting the gas to the atmsophere; the living quarters may have withstood the explosion and fire, had they been constructed of more substantial materials; had the wind directed the gas elsewhere the initial explosion may not have destroyed the living quarters; if the drilling crew had been able to close the kelly preventer valve at the base of the kelly the blowout could have been prevented; the presence of a sheer ram in the BOP stack would have allowed for a shut-in of the well bore; the numerous false alarms created by work on the platform alarm system brought about a situation where the drilling foreman decided to use a verbal alarm to abandon the platform rather than the alarm system and probably conditioned the crew members in the living quarters to a slower response than would normally be the case. (DP)

  3. [Micro-community characteristics of vegetations in blowouts and depositional areas of Hulunbuir grassland, Inner Mongolia].

    PubMed

    Man, Liang; Hasi, Eerdun; Zhang, Ping; Yan, Xu; Xia, Xian-Dong

    2008-10-01

    By using traditional sampling methods, the micro-communities of vegetations in fixed, semi-bare, and bare blowouts of Hulunbuir grassland were investigated, and the investigation data were statistical analyzed. The results showed that the vegetation coverage decreased in the order of fixed blowout, semi-bare blowout, and bare blowout, and was lower than that of the primary vegetation Form. Stipa grandis. Potentilla acaulis and Kengia squarrosa were the dominant species in fixed blowout, with the coverage being 5%; while P. acaulis and Carex sp. were the dominant species in semi-bare blowout, with the coverage being 2%. The dominant species in depositional areas of semi-bare blowout were P. acaulis, K. squarrosa, Agropyron cristatum, and Thymus mongolicus, and the coverage was 4%. The dominant species on the southwest slope of bare blowout was Agriophyllum pungens. The middle depositional area of bare blowout was also occupied by A. pungens (coverage 4.7%), and the edge of it was dominated by A. cristatum (coverage 2.7%), Carex sp. (coverage 2.6%), and T. mongolicus (coverage 1.7%) from the edge of the depositional area to primary grassland. The mean species importance value in fixed, semi-bare, and bare blowouts was 12.64%, 13.38%, and 20.08%, while that in the depositional area of semi-bare blowout and in the middle and edge of bare blowout was 12.55%, 40.18%, and 11.15%, respectively. PMID:19123352

  4. Coast Guard details causes of Gulf of Mexico offshore blowout

    SciTech Connect

    Ford, R.E.

    1980-11-17

    An investigation of the March 1979 gas blowout that occurred in the Gulf of Mexico, leading to an explosion, fire, and loss of personnel, reveals that the casualties may have been fewer if the rig personnel had responded immediately to the abandon-rig alarm. The proximate cause of the explosion was the loss of well control; natural gas flowed into the wellbore, up through the drill pipe, and into the strainer cross on the mud pump. There, it simultaneously blew out the gate valve on the pump recirculation line, lifted the pressure-relief valve, and forced the relief valve line to part, thus venting to the atmosphere. The gas accumulated under, around, and in the living quarters, pump room, and engine room. The resultant explosion completely destroyed the living quarters. Seriously contributing to the accident was the crew's inability to close the kelly preventer; the blowout-preventer stack functioned properly throughout the blowout.

  5. A computer-assisted analysis of trends among Gulf Coast blowouts

    SciTech Connect

    Hughes, V.M.P. . Region VI); Podio, A.L.; Sepehrnoori, K. . Dept. of Petroleum Engineering)

    1990-01-01

    Analysis of trends among 425 Gulf Coast blowouts through the utilization of a blowout data base indicates that the majority of the blowouts resulted from an influx of gas into the wellbore. The three major operations that were in progress when most of the wells blew out were drilling, coming out of the borehole, and workover procedures. The analysis also indicates that casing programs and blowout preventer selection should be improved. The introduction of mandatory well control training procedures in 1977--1978 seems to have assisted in the reduction of blowouts in relation to the number of wells drilled.

  6. Need for airbag and seatbelt to reduce orbital injuries from steering wheel knob.

    PubMed

    Hwang, Kun; Kim, Joo Ho

    2014-11-01

    The aims of this study are to report a blowout fracture of the orbital floor and medial wall caused by being struck by a steering wheel knob of an automobile and to discuss the use of airbags and seatbelts as a preventive measure for orbital injuries. A 58-year-old man was struck in the left eye by a steering wheel. His car hit a telephone pole, and he had a frontal collision injury. In this frontal impact, his left eye was hit by a Brodie knob attached to the steering wheel. At the time of injury, the speed of the car was about 65 km/h. He was not wearing a seatbelt, and the airbag had not deployed. Swelling and ecchymosis were observed at the left periorbital area, and he had diplopia on a left-side gaze. A CT revealed fractures in the medial and inferior wall of the left orbit. Entrapped soft tissues were reduced, and the medial wall and floor were reconstructed with a resorbable sheet. His diplopia disappeared 12 days after surgery. To prevent the injury from the steering wheel knob, an airbag should be installed in any vehicle, which has a steering wheel knob. Legislation mandating the use of airbags as well as seatbelts in vehicles with attached steering wheel knobs should be made. PMID:25376138

  7. Blowout control: Response, intervention and management; Part 5

    SciTech Connect

    Smestad, P.; Rygg, O.B. ); Wright, J.W. )

    1994-04-01

    All well control design functions depend on construction of an accurate computer hydraulics model of the blowout at hand. Such a model incorporates all available downhole data on characteristics of the reservoir, well effluent, pressure, temperature etc., and factors influencing the surface flowpath of the blow. In turn, the hydraulics data allows development of a blowout model and, finally, a workable well kill model that will indicate the most efficient kill/control method to use. The modeling process can be split into two phases: (1) establishing kill rates for different fluids, and maximum pressure and power requirements; (2) defining an operational kill plan and schedule. Establishing maximum rates, etc., can be done with steady state calculations. But dynamic (time based) calculations are needed to obtain kill volumes. Manually stepping a steady state simulator may also provide volumes. This paper reviews the application and requirement for such a model.

  8. High-rate Iranian blowout controlled while still burning

    SciTech Connect

    Bahmani, H.; Azarpanah, A. )

    1994-09-19

    Oil well firefighters used ingenuity and equipment designed in the field to cap a high-rate blowout well in Iran without extinguishing the fire. Well AZ-50, located about 25 km southeast of Ahwaz, Iran, blew out on Feb. 14, 1993, and was finally controlled on Mar. 31, 1993, by a firefighting team from the National Iranian Oil Co. The estimated open flow potential of producing Well AZ-50 was 60,000 bo/d and 50 MMsfd of associated gas, making this well among the world's largest blowouts. The well control operation was difficult because the flame height reached 117 m, the fluid velocity 2, 180 fps at the well-head, and the flame temperature 4,150 F. The paper describes operations.

  9. Blowout brought under control in Gulf of Mexico

    SciTech Connect

    Not Available

    1992-10-19

    This paper reports that Greenhill Petroleum Corp., Houston, killed a well blowout Oct. 9 and began cleaning up oil spilled into Timbalier Bay off La Fourche Parish, La. Development well No. 250 in Timbalier Bay field blew out Sept. 29 while Blake Drilling and Workover Co., Belle Chasse, La., was trying to recomplete it in a deeper zone. Fire broke out as Boots and Coots Inc., Houston, was positioning control equipment at the wellhead. State and federal oil spill response officials estimated the uncontrolled flow of well No. 250 at 1,400 b/d of oil. Coast Guard officials on Oct. 8 upgraded the blowout to a major spill, after deciding that at least 2,500 bbl of oil had gone into the water.

  10. Holocene Development and Progression of Aeolian Blowouts on Padre Island National Seashore

    NASA Astrophysics Data System (ADS)

    Jewell, M. E.; Houser, C.

    2012-12-01

    Recent evidence suggests that development of dune blowouts along Padre Island National Seashore, Texas, and migration of the parabolic dunes to the backbarrier shoreline are the primary mechanisms by which the island transgresses in response to relative sea level rise. This study characterizes the development and migration of dune blowouts at decadal and century scales in order to understand these changes. An initial breach, caused by the removal of vegetation, develops along the dune line allowing sediment to be funneled into the dune field. The entrance of the blowout focuses the wind velocity, allowing sediment to be transported into the dune field, covering any vegetation that is present. This process continues as sediment is eroded from the foredune increasing the size of the blowout until the foredune is rebuilt and vegetation stabilizes the entrance. With the front stabilized, the blowout begins its movement across the island. Aerial photographs, LIDAR data, ground penetrating radar, and optically stimulated luminescence were used to track and date the migration of these blowouts. Photographs and satellite images, taken at least twice a decade since the 1940s, were used to track blowouts from their initial conception to their final stabilization by vegetation. Each consecutive blowout was digitized to understand the surface characteristics of the feature. For a greater understanding of the system at the decadal scale, LIDAR data collected by the USGS and other agencies was used to create an elevation model in order compute the volumetric changes within the northern portion of the National Seashore. Within the larger study area, three smaller sites: a young blowout that had just begun to close as the foredune is reestablished, a "middle age" blowout that was detached from the foredune and become an active dune field, and a former blowout now stabilized by vegetation, were selected for geophysical analysis . A Trimble GX 3-D scanner was used to determine the

  11. Dune field reactivation from blowouts: Sevier Desert, UT, USA

    NASA Astrophysics Data System (ADS)

    Barchyn, Thomas E.; Hugenholtz, Chris H.

    2013-12-01

    Dune field reactivation (a shift from vegetated to unvegetated state) has important economic, social, and environmental implications. In some settings reactivation is desired to preserve environmental values, but in arid regions reactivation is typically a form of land degradation. Little is known about reactivation due to a lack of published records, making modeling and prediction difficult. Here we detail dune reactivations from blowout expansion in the Sevier Desert, Utah, USA. We use historical aerial photographs and satellite imagery to track the transition from stable, vegetated dunes to actively migrating sediment in 3 locations. We outline a reactivation sequence: (i) disturbance breaches vegetation and exposes sediment, then (ii) creates a blowout with a deposition apron that (iii) advances downwind with a slipface or as a sand sheet. Most deposition aprons are not colonized by vegetation and are actively migrating. To explore causes we examine local sand flux, climate data, and stream flow. Based on available data the best explanation we can provide is that some combination of anthropogenic disturbance and climate may be responsible for the reactivations. Together, these examples provide a rare glimpse of dune field reactivation from blowouts, revealing the timescales, behaviour, and morphodynamics of devegetating dune fields.

  12. Positron acceleration in doughnut wakefields in the blowout regime

    NASA Astrophysics Data System (ADS)

    Vieira, Jorge; Mendonca, Jose; Fonseca, Ricardo; Silva, Luis

    2014-10-01

    Most important plasma acceleration results were reached in the so called bubble or blowout regime. Although ideally suited for electron acceleration, it has been recognized that non-linear regimes are not adequate to accelerate positrons. New configurations enabling positron acceleration in non-linear regimes would therefore open new research paths for future plasma based collider configurations. In this work, we explore, analytically and through 3D OSIRIS simulations, a novel configuration for positron acceleration in strongly non-linear laser wakefield excitation regimes using Laguerre-Gaussian laser drivers to drive doughnut shaped wakefields with positron focusing and accelerating fields. We demonstrate that positron focusing-fields can be up to an order of magnitude larger than electron focusing in the spherical blowout regime. The amplitude of the accelerating fields is similar to the spherical blowout. Simulations demonstrate laser self-guiding and stable positron acceleration until the laser energy has been exhausted to the plasma. Other realisations of the scheme, using two Gaussian laser pulses, will also be explored. FCT Grant No EXPL/FIS-PLA/0834/2012 and European Research Council ERC-2010-AdG Grant No. 267841.

  13. Windflow circulation patterns in a coastal dune blowout, south coast of Lake Michigan

    USGS Publications Warehouse

    Fraser, G.S.; Bennett, S.W.; Olyphant, G.A.; Bauch, N.J.; Ferguson, V.; Gellasch, C.A.; Millard, C.L.; Mueller, B.; O'Malley, P. J.; Way, J.N.; Woodfield, M.C.

    1998-01-01

    The windflow patterns in a large active blowout in a coastal dune on the southern shore of Lake Michigan were intensively monitored during a two-day period when the predominant winds shifted from onshore (Day 1) to offshore (Day 2). The wind data were used in conjunction with mapped geomorphic features and sedimentologic characteristics to infer the following aspects of blowout evolution: (1) Prevailing winds are transformed considerably once they enter the blowout. Flow separation occurs when offshore winds enter the blowout over the steep back wall. Separated flows may, in turn, induce countercurrent flows within the trough. Flow expansion and deceleration occur when onshore winds enter over gently sloping walls at the front of the blowout. (2) Maximum erosion occurs along the deflationary floor near the entrance to the blowout, and lateral extensional lobes are also expanding the blowout to the east. Sand avalanches down the eastern and western lateral walls toward the deflationary floor where it is moved toward the rear of the blowout and up the ramp at the south end. Sand leaves the blowout as a series of depositional lobes prograding out onto the surface of the host dune along the south and east walls. (3) Vegetation prevents expansion of the blowout in certain directions and impediments to flow, such as slump blocks, alter circulation patterns and sand transport paths. (4) Prevailing onshore winds deflate the floor and promote eastward expansion of lateral erosional lobes, whereas strong flows from the southwest apparently are the main cause of transport up the transportational ramp and over the south wall of the blowout.

  14. Understanding Blowout Phenomena to the Induced Angle of V-Gutter-Stabilized Flames

    NASA Astrophysics Data System (ADS)

    Kirubhakaran, K.; Parammasivam, K. M.

    2016-04-01

    The combustion and flame blowout characteristics are investigated in a vitiated environment by placing the 60°, 90° and 120° V-gutters. The blowout is initiated through varying the equivalence ratio of reactants' flow rates. The blowout is mainly investigated in ultra-lean condition where the equivalence ratio ranges from 0.18 to 0.8, by varying the length of the combustor; the blowout of flame takes place more quickly; it occurred in all tested gutter angles. On increasing the gutter angle from 60° to 120° the flame blowout takes place at Reynolds number from 2,500 to 6,000, which is inversely proportional to the gutter-induced angle of the gutter. The flame flashback possibility occurs due to aggression of the flame marching towards the blowout. The 120° V-gutter has possible flashback since the blowout takes place at very low Reynolds number. As the length of the combustor increases, it is also evident that flashback phenomenon occurred in the rigorous flame just before the flame blowout.

  15. 30 CFR 250.516 - Blowout preventer system tests, inspections, and maintenance.

    Code of Federal Regulations, 2010 CFR

    2010-07-01

    ... Well-Completion Operations § 250.516 Blowout preventer system tests, inspections, and maintenance. (a... 30 Mineral Resources 2 2010-07-01 2010-07-01 false Blowout preventer system tests, inspections, and maintenance. 250.516 Section 250.516 Mineral Resources MINERALS MANAGEMENT SERVICE, DEPARTMENT...

  16. Well blowout rates in California Oil and Gas District 4--Update and Trends

    SciTech Connect

    Jordan, Preston D.; Benson, Sally M.

    2009-10-01

    Well blowouts are one type of event in hydrocarbon exploration and production that generates health, safety, environmental and financial risk. Well blowouts are variously defined as 'uncontrolled flow of well fluids and/or formation fluids from the wellbore' or 'uncontrolled flow of reservoir fluids into the wellbore'. Theoretically this is irrespective of flux rate and so would include low fluxes, often termed 'leakage'. In practice, such low-flux events are not considered well blowouts. Rather, the term well blowout applies to higher fluxes that rise to attention more acutely, typically in the order of seconds to days after the event commences. It is not unusual for insurance claims for well blowouts to exceed US$10 million. This does not imply that all blowouts are this costly, as it is likely claims are filed only for the most catastrophic events. Still, insuring against the risk of loss of well control is the costliest in the industry. The risk of well blowouts was recently quantified from an assembled database of 102 events occurring in California Oil and Gas District 4 during the period 1991 to 2005, inclusive. This article reviews those findings, updates them to a certain extent and compares them with other well blowout risk study results. It also provides an improved perspective on some of the findings. In short, this update finds that blowout rates have remained constant from 2005 to 2008 within the limits of resolution and that the decline in blowout rates from 1991 to 2005 was likely due to improved industry practice.

  17. A Slow Streamer Blowout at the Sun and Ulysses

    NASA Technical Reports Server (NTRS)

    Suess, S. T.; Bemporad, A.; Poletto, G.

    2003-01-01

    On 10 June 2000 a streamer on the southeast limb slowly disappeared from LASCO/C2 over a period of 17 hours. Within this interval, a small CME was reported in C2. Nothing was reported in C3. The ejecta was later detected at Ulysses, which was at quadrature with the Sun and SOHO at the time. The interplanetary CME (ICME) displayed all the properties of a typical ICME. Slow streamer blowouts such as this have long been known but are little studied.

  18. Numerical Simulation of a Slow Streamer-Blowout CME

    NASA Astrophysics Data System (ADS)

    Lynch, Benjamin J.; Masson, Sophie; Li, Yan; DeVore, C. Richard; Luhmann, Janet; Antiochos, Spiro K.

    2014-06-01

    We present a 3D numerical MHD simulation of the 2008 Jun 2 gradual streamer blowout CME that had virtually no identifiable low coronal signatures. We energize the field by simple footpoint shearing along the source region's polarity inversion line and model the background solar wind structure using an ˜2MK isothermal wind and a low-order potential field source surface representation of the CR2070 synoptic magnetogram. Our results show that the CME ``initiation’’ is obtained by slowly disrupting the quasi-steady-state configuration of the helmet streamer, resulting in the standard eruptive flare picture that ejects the sheared fields, but very slowly, on a relatively large scale, and with very little magnetic energy release. We obtain a relatively slow CME eruption of order the background solar wind speed and argue that these slow streamer blowout CMEs (now also known as ``stealth CMEs’’) are simply at the lowest end of the CME energy distribution. We present comparisons of the CME propagation through the corona (≤15Rs) in synthetic white-light images derived from the simulation density structure with multi-spacecraft coronagraph data from STEREO/SECCHI and SOHO/LASCO.

  19. A Slow Streamer Blowout at the Sun and Ulysses

    NASA Technical Reports Server (NTRS)

    Seuss, S. T.; Bemporad, A.; Poletto, G.

    2004-01-01

    On 10 June 2000 a streamer on the southeast limb slowly disappeared from LASCO/C2 over approximately 10 hours. A small CME was reported in C2. A substantial interplanetary CME (ICME) was later detected at Ulysses, which was at quadrature with the Sun and SOHO at the time. This detection illustrates the properties of an ICME for a known solar source and demonstrates that the identification can be done even beyond 3 AU. Slow streamer blowouts such as this have long been known but are little studied. We report on the SOHO observation of a coronal mass ejection (CME) on the solar limb and the subsequent in situ detection at Ulysses, which was near quadrature at the time, above the location of the CME. SOHO-Ulysses quadrature was 13 June, when Ulysses was 3.36 AU from the Sun and 58.2 degrees south of the equator off the east limb. The slow streamer blowout was on 10 June, when the SOHO-Sun-Ulysses angle was 87 degrees.

  20. Meso-scale aeolian transport of beach sediment via dune blowout pathways within a linear foredune

    NASA Astrophysics Data System (ADS)

    O'Keeffe, Nicholas; Delgado-Fernandez, Irene; Jackson, Derek; Aplin, Paul; Marston, Christopher

    2016-04-01

    The evolution of coastal foredunes is largely controlled by sediment exchanges between the geomorphic sub-units of the nearshore, beach, foredune and dune field. Although blowouts are widely recognised as efficient sediment transport pathways, both event-scale and meso-scale quantification of their utility in transferring beach sediments landwards is limited. Foredunes characterised by multiple blowouts may be more susceptible to coastline retreat through the enhanced landwards transport of beach or foredune sediments. To date, a key constraint for investigations of such scenarios has been the absence of accurate blowout sediment transport records. Here we use the Sefton coast in north-west England as a study area where an unprecedented temporal coverage of LIDAR data is available between 1999 and 2015. Additionally, an extensive set of aerial photography also exists, dating back to 1945 allowing comparison of blowout frequency and magnitude together with the alongshore limits of coastline retreat. Digital terrain models are derived for each year that LIDAR data is available. Informed by LIDAR based topography and areas of bare sand (aerial photos) terrain models have been created containing individual blowouts. Differentials in 'z' values between each terrain model of each available year has identified topographic change and total levels of transport. Preliminary results have confirmed the importance of blowouts in transporting beach or foredune sediment landwards and thus potentially promoting coastline retreat. Repetition of processes across a larger number of blowout topographies will allow better identification of individual blowouts for 'event' scale field investigations to examine spatial and temporal variability of beach sediment transport via blowouts routes.

  1. India gas well blowout capped and killed in 17 days

    SciTech Connect

    1995-06-01

    On January 8, 1995, the Pasarlapudi 19 gas well being drilled by India`s ONGC (oil and Natural Gas Corp.) near Amalapuram, India, 295 miles east of the state capital, Hyderabad, blew out while the operator was retrieving a stuck fish in deviated hole. On February 26, ONGC awarded a well control contract to International Well Control (IWC), Houston. On March 15, IWC and ONGC`s Crisis Management Team (CMT) completed extinguishing the fire, capping the well and killing the blowout, which was described by the experienced team as one of the two or three biggest they had ever seen. The article describes how the fire was extinguished and the well was capped, procedures heavily dependent on successful application of an abrasive fluid cutter supplied by Halliburton Energy Services (HES).

  2. Blowout Jets: Evidence from Hinode/XRT for X-Ray Jets Made by Blowout Eruption of the Emerging Bipole

    NASA Technical Reports Server (NTRS)

    Moore, Ronald L.; Cirtain, Jonathan W.; Sterling, Alphonse C.

    2009-01-01

    Yamauchi et al (2004, ApJ, 605, 511) found that there are two structurally and dynamically distinct types of H macrospicules in polar coronal holes: single-column jet macrospicules and erupting-loop macrospicules. The structure and motion of the single-column jet macrospicules fit the standard Shibata reconnection picture for solar X-ray jets (Shibata et al 1992, PASJ, 44, L173). The form and motion of the erupting-loop macrospicules is reminiscent of the ejective eruption of the sheared-core-field flux rope in the filament-eruption birth of a bubble-type coronal mass ejection (CME). That roughly half of all polar H macrospicules were observed to be erupting-loop macrospicules suggests that there should be a corresponding large class of X-ray jets in which the emerging bipole at the base of the jet undergoes a blowout eruption as in a bubble-type CME, instead of staying closed as in the standard picture for X-ray jets. Along with a cartoon of the standard picture, we present a cartoon depicting the signatures to be expected of a blowout jet in high-resolution coronal X-ray movies such as from Hinode/XRT. From Hinode/XRT movies in polar coronal holes, we show: (1) examples of X-ray jets that fit the standard picture very well, and (2) other examples that do not fit the standard picture but do show signatures appropriate for blowout jets. These signatures are (1) a flare arcade inside the emerging bipole in addition to the flare arcade produced between the emerging bipole and the ambient high-reaching unipolar field by reconnection of these two fields as in the standard picture, and (2) in addition to the jet prong expected from the standard reconnection, a second jet prong or strand, one that could not be produced by the standard reconnection but could be produced by reconnection between the ambient unipolar field and one leg of an erupting core-field flux rope that has blown out the emerging bipole. We therefore infer that these "two pronged" jets are made by

  3. Windflow circulation patterns in a blowout in coastal dunes along the southern shore of Lake Michigan

    SciTech Connect

    Bauch, N.J.; Bennett, S.; Ferguson, V.; Fraser, G.S.; Gellasch, C.A.; Millard, C.L.; Mueller, B.; O'Malley, P.J.; Way, J.N.; Woodfield, M.C. . Dept. of Geosciences)

    1993-03-01

    The windflow patterns in one of several large active blowouts in the coastal dunes along the southern shore of Lake Michigan was intensively monitored over a two-day period. Two wind towers, consisting of four sets of anemometer cups mounted at 20-, 40-, 80, and 160-cm heights above the base, were used to provide a velocity profile from which basal shear velocities could be calculated. A wind vane was mounted at the top of the tower to monitor wind directions. Data was collected continuously with digital data loggers and averaged over 1-min intervals, and each station was occupied for a 5-min period. The topography of the blowout was mapped with a transit, which also was used to establish the position and elevation of the authors data-collecting stations. Photomosaics were used to prepare a map of the geomorphic elements. The elliptical blowout is 100m long and approximately 25m wide. Its floor drops slightly in elevation from the mouth, and then rises to a height of 32 meters at the back wall. The walls of the blowout assume smooth parabolic shapes except where undercutting at the margins has produced several large slump blocks. Windflow entering the blowout at the mouth and sides separates at the point of maximum expansion and veers as much as 100[degree]. Maximum velocities occur at the point of reattachment, and deceleration occurs as the wind proceeds into the blowout. Axial flows may accelerate toward the back wall where flow compression occurs. Flows entering the blowout at the back wall separate at the margin. As they overflow the blowout, they produce a reverse flow circulation that is strongest near the mouth and decelerates rapidly up the axis.

  4. Reactivation of supply-limited dune fields from blowouts: A conceptual framework for state characterization

    NASA Astrophysics Data System (ADS)

    Barchyn, Thomas E.; Hugenholtz, Chris H.

    2013-11-01

    Aeolian dune fields mantle the Earth in both vegetated (stable) and unvegetated (active) states. Changes in state are poorly understood; in particular, little is known about reactivation (devegetation) from a vegetated state. Available evidence indicates that dune reactivation can be driven by changes in aridity, increased wind speed, fire, biogenic disturbance, human disturbance, or a combination of the previous. How these controls fit together and define the reactivation potential of dune fields is presently unknown. Here we develop a framework to describe reactivation potential for a specific case: presently vegetated, supply-limited dune fields that develop blowouts under a unidirectional wind. We first define a conceptual model of blowout expansion, and then split the functions of vegetation in a stable dune field into: (i) maintenance of a protective skin, and (ii) blowout suppression. We model reactivation as disturbance breaking through the protective skin, which forms a blowout that is either (i) suppressed by colonizer species, or (ii) capable of advancing downwind and reactivating part of the dune field. The capacity for disturbance to break through the protective skin is a function of disturbance magnitude, area, and resistance of the skin. The blowout suppression capacity of a dune field is a function of sediment flux, blowout depth (related to geomorphology), and colonizer species vitality. By plotting a given dune field with two variables (protective skin breach rate and blowout suppression capacity) we define four states: (i) stable, (ii) blowout dominated, (iii) reactivating, or (iv) stable but disturbance susceptible. We reinforce the conceptual model with qualitative examples and discussion of experiments on grassland-stabilized dunes in Canada. Overall, our framework provides a starting point for quantifying the reactivation potential of vegetated dune fields.

  5. Nose fracture

    MedlinePlus

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It ... with other fractures of the face. Sometimes a blunt injury can ...

  6. Morphometrics of aeolian blowouts from high-resolution digital elevation data: methodological considerations, shape metrics, and scaling

    NASA Astrophysics Data System (ADS)

    Hamilton, T. K.; Duke, G.; Brown, O.; Koenig, D.; Barchyn, T. E.; Hugenholtz, C.

    2011-12-01

    Aeolian blowouts are wind erosion hollows that form in vegetated aeolian landscapes. They are especially pervasive in dunefields of the northern Great Plains, yielding highly pitted or hummocky terrain, and adding to the spatial variability of microenvironments. Their development is thought to be linked to feedbacks between morphology and airflow; however, few measurements are available to test this hypothesis. Currently, a dearth of morphology data is limiting modeling progress. From a systematic program of blowout mapping with high-resolution airborne LiDAR data, we used a GIS to calculate morphometrics for 1373 blowouts in Great Sand Hills, Saskatchewan, Canada. All of the blowouts selected for this investigation were covered by grassland vegetation and inactive; their morphology represents the final stage of evolution. We first outline methodological considerations for delineating blowouts and measuring their volume. In particular, we present an objective method to enhance edge and reduce operator error and bias. We show that blowouts are slightly elongate and 49% of the sample blowouts are oriented parallel to the prevailing westerly winds. We also show that their size distribution is heavy-tailed, meaning that most blowouts are relatively small and rarely increase in size beyond 400 m3. Given that blowout growth is dominated by a positive feedback between sediment transport and vegetation erosion, these results suggest several possible mechanisms: i) blowouts simultaneously evolved and stabilized as a result of external climate forcing, ii) blowouts are slaved to exogenous biogenic disturbance patterns (e.g., bison wallows), or iii) a morphodynamic limiting mechanism restricts blowout size. Overall, these data will serve as a foundation for future study, providing insight into an understudied landform that is common in many dunefields.

  7. Morphology and Sediment Transport Dynamics of a Trough-Blowout Dune, Bodega Marine Reserve, Northern California

    NASA Astrophysics Data System (ADS)

    Jorgenson, D.; Dunleavy, C. J.; Smith, M. E.

    2014-12-01

    Blowout dunes are a primary mechanism for transporting sand within vegetated coastal dune systems. Understanding the fine-scale variation in sediment transport within these systems is critical to predicting their formation and migration. Previous investigations of a coastal dune system located at the Bodega Marine Reserve, on the Sonoma Coast of Northern California have indicated that aeolian sand flux in unvegetated sand is ~450x greater than in vegetated areas. To better understand sand flux and its relationship with wind speed, direction and precipitation, we deployed an array of 12 sand traps within a single blowout area adjacent to the BOON marine climatology station. The blowout is trough- shaped, approximately 50 meters long and 15 meters wide. Its main 'fairway' is 5-10 meters below the surrounding beach grass (Ammophila)-covered land surface. Surface sediment within the blowout is fine-grained to granule-sized lithic to sub-lithic sand, and is coarsest in the center. Dune sediment in the Bodega Marine Reserve has been transported by aeolian processes from Salmon Creek Beach to the NW. Within the blowout, typical bedforms include 15-25 cm-wavelength, ~10 cm high sinuous to lingoid ripples arranged perpendicularly to the dominant wind direction (~280 degrees). An 8-10 meter-high mound at the downwind end has accumulated due to the trapping of sand flux by vegetation. Sediment flux across the studied blowout was sampled monthly over a 10-month period of 2013-2014. Sand traps were constructed using modified PVC cylinders, and are 0.5 meter high and 0.3 meter in diameter, with a 0.74-micron mesh screen. Based on measured sand flux, the sites can be categorized into three groups-axial, medial, and peripheral. Rates increase downwind within the blowout. Inter-site sand flux variability within unvegetated locations of the blowout is greater than two orders of magnitude. Axial sites, which experience the greatest sand flux, occur on the edge of the blowout adjacent

  8. Three-dimensional æolian dynamics within a bowl blowout during offshore winds: Greenwich Dunes, Prince Edward Island, Canada

    NASA Astrophysics Data System (ADS)

    Hesp, Patrick A.; Walker, Ian J.

    2012-01-01

    This paper examines the æolian dynamics of a deep bowl blowout within the foredune of the Greenwich Dunes, on the northeastern shore or Prince Edward Island, Canada. Masts of cup anemometers and sonic anemometers were utilized to measure flow velocities and directions during a strong regional ESE (offshore) wind event. The flow across the blowout immediately separated at the upwind rim crest, and within the blowout was strongly reversed. High, negative vertical flows occurred down the downwind (but seaward) vertical scarp which projected into the separation envelope and topographically forced flow back into the blowout. A pronounced, accelerated jet flow existed near the surface across the blowout basin, and the flow exhibited a complex, anti-clockwise structure with the near-surface flow following the contours around the blowout basin and lower slopes. Significant æolian sediment transport occurred across the whole bowl basin and sediment was delivered by saltation and suspension out the blowout to the east. This study demonstrates that strong offshore winds produce pronounced topographically forced flow steering, separation, reversal, and more complex three-dimensional motions within a bowl blowout, and that such winds within a bowl blowout play a notable role in transporting sediment within and beyond deep topographic hollows in the foredune.

  9. Nose fracture

    MedlinePlus

    Fracture of the nose; Broken nose; Nasal fracture; Nasal bone fracture; Nasal septal fracture ... A fractured nose is the most common fracture of the face. It usually occurs after an injury and often occurs with ...

  10. Fluid injection apparatus and method used between a blowout preventer and a choke manifold

    SciTech Connect

    Hailey, C.D.

    1986-10-21

    An apparatus is described for pumping fluid into a blowout preventer through a first opening thereof and into a choke manifold through a second opening thereof. The apparatus comprises: a base frame; fluid container means, mounted on the base frame, for receiving the fluid to be pumped into the blowout preventer and the choke manifold; pump means, mounted on the base frame, for pumping the fluid of the fluid container means through a flow inlet and an outlet of the pump means; and spacer flange coupling means, connectible between the first and second openings, for coupling the outlet of the pump means with the blowout preventer and the choke manifold. A method is described of injecting a fluid into a blowout preventer. The method consists of: connecting to the choke flow line and the inlet, between the first and second valve means, flow port means for providing a fluid communication path between the choke flow line of the blowout preventer and the inlet of the choke manifold and for providing an injection port into the fluid communication path; and pumping the fluid into the injection port so that the fluid is dispersed through the fluid communication path towards the first and second valve means.

  11. Skull fracture

    MedlinePlus

    Basilar skull fracture; Depressed skull fracture; Linear skull fracture ... Skull fractures may occur with head injuries . The skull provides good protection for the brain. However, a severe impact ...

  12. Development of an automatic subsea blowout preventer stack control system using PLC based SCADA.

    PubMed

    Cai, Baoping; Liu, Yonghong; Liu, Zengkai; Wang, Fei; Tian, Xiaojie; Zhang, Yanzhen

    2012-01-01

    An extremely reliable remote control system for subsea blowout preventer stack is developed based on the off-the-shelf triple modular redundancy system. To meet a high reliability requirement, various redundancy techniques such as controller redundancy, bus redundancy and network redundancy are used to design the system hardware architecture. The control logic, human-machine interface graphical design and redundant databases are developed by using the off-the-shelf software. A series of experiments were performed in laboratory to test the subsea blowout preventer stack control system. The results showed that the tested subsea blowout preventer functions could be executed successfully. For the faults of programmable logic controllers, discrete input groups and analog input groups, the control system could give correct alarms in the human-machine interface. PMID:21889767

  13. LES of combustion dynamics near blowout in a realistic gas-turbine combustor

    NASA Astrophysics Data System (ADS)

    Esclapez, Lucas; Nik, Medhi B.; Ma, Peter C.; O'Brien, Jeff; Carbajal, Serena; Ihme, Matthias

    2015-11-01

    Driven by increasingly stringent emission regulations, modern gas turbines operate at lean conditions to reduce combustion chamber temperature and NOx emissions. However, as the combustor operates closer to the lean blow-out (LBO) limit, flame stabilization mechanisms are weakened, which increases the risk for complete flame blowout. To better understand the LBO-process, large-eddy simulations of the combustion dynamics near blowout are performed in a realistic two-phase flow combustor. An unstructured incompressible Navier-Stokes solver is used in combination with a Lagrangian dispersed phase formulation. Flame dynamics near and at LBO conditions are studied to identify the role of the liquid fuel composition, spray evaporation, and complex flow pattern on the LBO limit.

  14. A Review of Seafood Safety after the Deepwater Horizon Blowout

    PubMed Central

    Doke, Dzigbodi; Tipre, Meghan; Leader, Mark; Fitzgerald, Timothy

    2011-01-01

    Background: The Deepwater Horizon (DH) blowout resulted in fisheries closings across the Gulf of Mexico. Federal agencies, in collaboration with impacted Gulf states, developed a protocol to determine when it is safe to reopen fisheries based on sensory and chemical analyses of seafood. All federal waters have been reopened, yet concerns have been raised regarding the robustness of the protocol to identify all potential harmful exposures and protect the most sensitive populations. Objectives: We aimed to assess this protocol based on comparisons with previous oil spills, published testing results, and current knowledge regarding chemicals released during the DH oil spill. Methods: We performed a comprehensive review of relevant scientific journal articles and government documents concerning seafood contamination and oil spills and consulted with academic and government experts. Results: Protocols to evaluate seafood safety before reopening fisheries have relied on risk assessment of health impacts from polycyclic aromatic hydrocarbon (PAH) exposures, but metal contamination may also be a concern. Assumptions used to determine levels of concern (LOCs) after oil spills have not been consistent across risk assessments performed after oil spills. Chemical testing results after the DH oil spill suggest PAH levels are at or below levels reported after previous oil spills, and well below LOCs, even when more conservative parameters are used to estimate risk. Conclusions: We recommend use of a range of plausible risk parameters to set bounds around LOCs, comparisons of post-spill measurements with baseline levels, and the development and implementation of long-term monitoring strategies for metals as well as PAHs and dispersant components. In addition, the methods, results, and uncertainties associated with estimating seafood safety after oil spills should be communicated in a transparent and timely manner, and stakeholders should be actively involved in developing a long

  15. Relief-well requirements to kill a high-rate gas blowout from a deepwater reservoir

    SciTech Connect

    Warriner, R.A. ); Cassity, T.G. )

    1988-12-01

    Relief-well requirements were investigated for a dynamic kill of a high-rate gas blowout from a deepwater reservoir to define any necessary special procedures or equipment. Results of the investigation show that a high injection rate and a special-design large-diameter injection riser are required to dynamically kill such a blowout with seawater. The injection riser is necessary to limit surface pump pressure during the high-rate kill operation. Procedures to complete the kill operation hydrostatically with heavy fluid following the dynamic kill are outlined.

  16. One-side riddled basin below and beyond the blowout bifurcation

    NASA Astrophysics Data System (ADS)

    Yang, H. L.

    2000-10-01

    In this Rapid Comunication we report a phenomenon of a one-side riddled basin where one side of the basin of attraction of an attractor on an invariant subspace (ISS) is globally riddled, while the other side is only locally riddled. This kind of basin appears due to the symmetry breaking with respect to the ISS. This one-side riddled basin can even persist beyond the blowout bifurcation, contrary to the previously reported riddled basins which exist only below the blowout transition. An experimental situation where this phenomenon can be expected is proposed.

  17. One-side riddled basin below and beyond the blowout bifurcation

    PubMed

    Yang

    2000-10-01

    In this Rapid Comunication we report a phenomenon of a one-side riddled basin where one side of the basin of attraction of an attractor on an invariant subspace (ISS) is globally riddled, while the other side is only locally riddled. This kind of basin appears due to the symmetry breaking with respect to the ISS. This one-side riddled basin can even persist beyond the blowout bifurcation, contrary to the previously reported riddled basins which exist only below the blowout transition. An experimental situation where this phenomenon can be expected is proposed. PMID:11089070

  18. Fracture detection logging tool

    DOEpatents

    Benzing, William M.

    1992-06-09

    A method and apparatus by which fractured rock formations are identified and their orientation may be determined includes two orthogonal motion sensors which are used in conjunction with a downhole orbital vibrator. The downhole vibrator includes a device for orienting the sensors. The output of the sensors is displayed as a lissajou figure. The shape of the figure changes when a subsurface fracture is encountered in the borehole. The apparatus and method identifies fractures rock formations and enables the azimuthal orientation of the fractures to be determined.

  19. [Diseases of the orbit].

    PubMed

    Lukasik, S; Betkowski, A; Cyran-Rymarz, A; Szuber, D

    1995-01-01

    Diseases of the orbital cavity require more attention because of its specific anatomic structure and placement. Their curing requires cooperation of many medical specialties. Analysis consider orbital fractures, mainly caused by car accidents (69.2%). The next half of them consider inflammatory processes and tumor in equal numbers. Malignant tumors of orbital cavity occur most frequently (48.0%), less frequent are pseudotumors--pseudotumor orbitae (36.0%) and rare--malignant ones (16.0%). Malignant tumors more frequently infiltrate the orbit in neighborhood (63.3%), less frequently they come out from orbit tissue (16.7%). It should be emphasized that the number of orbit inflammations decreases in subsequent years, whereas occurrence of orbit tumors increases. PMID:9454170

  20. Management of ocular, orbital, and adnexal trauma

    SciTech Connect

    Spoor, T.C.; Nesi, F.A.

    1988-01-01

    This book contains 20 chapters. Some of the chapter titles are: The Ruptured Globe: Primary Care; Corneal Trauma, Endophthalmitis; Antibiotic Usage; Radiology of Orbital Trauma; Maxillofacial Fractures; Orbital Infections; and Basic Management of Soft Tissue Injury.

  1. Endovascular Management of Post-Irradiated Carotid Blowout Syndrome

    PubMed Central

    Chang, Feng-Chi; Luo, Chao-Bao; Lirng, Jiing-Feng; Lin, Chung-Jung; Lee, Han-Jui; Wu, Chih-Chun; Hung, Sheng-Che; Guo, Wan-Yuo

    2015-01-01

    Purpose To retrospectively evaluate the clinical and technical factors related to the outcomes of endovascular management in patients with head-and-neck cancers associated with post-irradiated carotid blowout syndrome (PCBS). Materials and Methods Between 2000 and 2013, 96 patients with PCBS underwent endovascular management. The 40 patients with the pathological lesions located in the external carotid artery were classified as group 1 and were treated with embolization. The other 56 patients with the pathological lesions located in the trunk of the carotid artery were divided into 2 groups as follows: group 2A comprised the 38 patients treated with embolization, and group 2B comprised the 18 patients treated with stent-graft placement. Fisher’s exact test was used to examine endovascular methods, clinical severities, and postprocedural clinical diseases as predictors of outcomes. Results Technical success and immediate hemostasis were achieved in all patients. The results according to endovascular methods (group 1 vs 2A vs 2B) were as follows: technical complication (1/40[2.5%] vs 9/38[23.7%] vs 9/18[50.0%], P = 0.0001); rebleeding (14/40[35.0%] vs 5/38[13.2%] vs 7/18[38.9%]), P = 0.0435). The results according to clinical severity (acute vs ongoing PCBS) were as follows: technical complication (15/47[31.9%] vs 4/49[8.2%], P = 0.0035); rebleeding (18/47[38.3%] vs 8/49[16.3%], P = 0.0155). The results according to post-procedural clinical disease (regressive vs progressive change) were as follows: alive (14/21[66.7%] vs 8/75[10.7%], P<0.0001); survival time (34.1±30.6[0.3–110] vs 3.6±4.0[0.07–22] months, P<0.0001). Conclusion The outcomes of endovascular management of PCBS can be improved by taking embolization as a prior way of treatment, performing endovascular intervention in slight clinical severity and aggressive management of the post-procedural clinical disease. PMID:26439632

  2. 30 CFR 250.616 - Blowout preventer system testing, records, and drills.

    Code of Federal Regulations, 2011 CFR

    2011-07-01

    ... ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Oil and Gas Well-Workover Operations § 250.616 Blowout preventer system testing, records, and... engaged in well-workover operations shall participate in a weekly BOP drill to familiarize crew...

  3. 30 CFR 250.1611 - Blowout preventer systems tests, actuations, inspections, and maintenance.

    Code of Federal Regulations, 2012 CFR

    2012-07-01

    ... 30 Mineral Resources 2 2012-07-01 2012-07-01 false Blowout preventer systems tests, actuations, inspections, and maintenance. 250.1611 Section 250.1611 Mineral Resources BUREAU OF SAFETY AND ENVIRONMENTAL ENFORCEMENT, DEPARTMENT OF THE INTERIOR OFFSHORE OIL AND GAS AND SULPHUR OPERATIONS IN THE OUTER CONTINENTAL SHELF Sulphur Operations...

  4. Blowout control. Part 1. Surface kill procedures use existing equipment for control

    SciTech Connect

    Adams, N.

    1980-09-22

    Procedures for controlling both underground and surface blowouts are expensive, difficult to implement, and not always successful. The primary concern is environmental protection, but if toxic gases such as hydrogen sulfide are involved, the safety of human life becomes the paramount consideration. The cost of a blowout includes losses of equipment and hydrocarbons, personnel and equipment costs incurred in regaining control of the well, and the expenses involved in protecting the surrounding area. Proper planning in every phase of surface-kill procedure is essential to its speed and success. A special task force should coordinate all activities during the kill operation. All of the available surface-kill techniques involve pumping a sufficient quantity of fluids such as mud or cement into the well to overbalance the formation pressure of the flowing zones. Shut-in at the surface is preferable, but drilling an intersecting relief well can become necessary if the casing string is not accessible. Usually, the operation will require special equipment such as explosives, sheets of corrugated iron, and asbestos suits. For an annular blowout, the kill procedure involves either installing new control equipment or repairing the existing blowout preventers, then shutting in or capping the well and pumping mud into it.

  5. A method for planning well control operations involving an induced fracture

    SciTech Connect

    Negrao, A.F.; Bourgoyne, A.T.

    1996-09-01

    Although many ways (the use of barite plugs, cementing, packers, etc.) to control underground blowouts exist, this paper will focus on the dynamic kill method as a mean to regain the control of the well. The dynamic kill method is a well control procedure that calls for pumping down the drill pipe with a flow rate that causes the bottom hole pressure to exceed the formation pressure, thus displacing the fluids out of the annulus. The process consists of varying the mud flow rate, and calculating for each flow rate the hydrostatic pressure and the losses occurring in the annulus of the well. The bottom hole pressure is then calculated by adding the hydrostatic pressure and the pressure losses to the fracture initiation pressure which is considered constant. This process is unrealistic because the fracture initiation pressure will change with time as the fracture propagates and as the flow rate is increased. The main objective of this study is to evaluate when the assumption of a constant fracture injection pressure will lead to unacceptable errors in the design of a dynamic kill procedure. The evaluation is accomplished using a new computer model that couples a hydraulic fracture model with conventional reservoir and wellbore models using a system analysis approach. The program can predict fracture dimensions and fracture pressure in any cross section of the fracture as well as pressure in any part of the wellbore. The program emphasizes the bottom hole pressure, pressure in front of the fracture and producing gas during the underground blowout.

  6. Corrigendum to "Dune field reactivation from blowouts: Sevier Desert, UT, USA" [Aeolian Res. 11 (2013) 75-84

    NASA Astrophysics Data System (ADS)

    Barchyn, Thomas E.; Hugenholtz, Chris H.

    2016-06-01

    This corrigendum corrects an error made in the flux calculations in 'Dune field reactivation from blowouts: Sevier Desert, UT, USA'. The corrected data differ only slightly from the original publication and do not affect the conclusions of the paper.

  7. 76 FR 49666 - Safety Zone; East Coast Drag Boat Bucksport Blowout Boat Race, Waccamaw River, Bucksport, SC

    Federal Register 2010, 2011, 2012, 2013, 2014

    2011-08-11

    ...The Coast Guard is establishing a temporary safety zone on the waters of the Waccamaw River during the East Coast Drag Boat Bucksport Blowout in Bucksport, South Carolina. The East Coast Drag Boat Bucksport Blowout will consist of a series of high-speed boat races. The event is scheduled to take place on Saturday, September 17, 2011 and Sunday, September 18, 2011. The temporary safety zone is......

  8. Spatial-temporal evolution of aeolian blowout dunes at Cape Cod

    NASA Astrophysics Data System (ADS)

    Abhar, Kimia C.; Walker, Ian J.; Hesp, Patrick A.; Gares, Paul A.

    2015-05-01

    This paper explores historical evolution of blowouts at Cape Cod National Seashore (CCNS), USA - a site that hosts one of the world's highest densities of active and stabilized blowouts. The Spatial-Temporal Analysis of Moving Polygons (STAMP) method is applied to a multi-decadal dataset of aerial photography and LiDAR to extract patterns of two-dimensional movement and morphometric changes in erosional deflation basins and depositional lobes. Blowout development in CCNS is characterized by several geometric (overlap) and movement (proximity) responses, including: i) generation and disappearance, ii) extension and contraction, iii) union or division, iv) clustering and v) divergence by stabilization. Other possible movement events include migration, amalgamation and proximal stabilization, but they were not observed in this study. Generation events were more frequent than disappearance events; the former were highest between 1985 and 1994, while the latter were highest between 2000 and 2005. High rates of areal change in erosional basins occurred between 1998 and 2000 (+ 3932 m2 a-1), the lowest rate (+ 333 m2 a-1) between 2005 and 2009, and the maximum rate (+ 4589 m2 a-1) between 2009 and 2011. Union events occurred mostly in recent years (2000-2012), while only one division was observed earlier (1985-1994). Net areal changes of lobes showed gradual growth from a period of contraction (- 1119 m2 a-1) between 1998 and 2000 to rapid extension (+ 2030 m2 a-1) by 2010, which is roughly concurrent with rapid growth of erosional basins between 2005 and 2009. Blowouts extended radially in this multi-modal wind regime and, despite odd shapes initially, they became simpler in form (more circular) and larger over time. Net extension of erosional basins was toward ESE (109°) while depositional lobes extended SSE (147°). Lobes were aligned with the strongest (winter) sand drift vector although their magnitude of areal extension was only 33% that of the basins. These

  9. HELICAL BLOWOUT JETS IN THE SUN: UNTWISTING AND PROPAGATION OF WAVES

    SciTech Connect

    Lee, E. J.; Archontis, V.; Hood, A. W.

    2015-01-01

    We report on a numerical experiment of the recurrent onset of helical ''blowout'' jets in an emerging flux region. We find that these jets are running with velocities of ∼100-250 km s{sup –1} and they transfer a vast amount of heavy plasma into the outer solar atmosphere. During their emission, they undergo an untwisting motion as a result of reconnection between the twisted emerging and the non-twisted pre-existing magnetic field in the solar atmosphere. For the first time in the context of blowout jets, we provide direct evidence that their untwisting motion is associated with the propagation of torsional Alfvén waves in the corona.

  10. Physical Parameters of a Blowout Jet Observed by HINODE and STEREO/EUVI

    NASA Astrophysics Data System (ADS)

    Pucci, S.; Poletto, G.; Sterling, A.; Romoli, M.

    2012-05-01

    The present work aims at identifying a typical blowout jet and inferring its physical parameters. To this end, we present a preliminary multi-instrument analysis of the bright X-ray jet that occurred in the north polar coronal hole on Nov. 3, 2007, at 11:50 UT. The jet shows the typical characteristics of “blowout jets'' (Moore et al. 2010), and was observed by Hinode/X-Ray Telescope (XRT) and by Stereo/Extreme UltraViolett Imager (EUVI) and COR1. Temperatures and Emission Measures (EMs) of the jet have been derived from the EUVI A data via the filter ratio technique in the pre-event, near maximum and in the post-maximum phases. Temperatures and EMs inferred from EUVI data are then used to calculate the predicted XRT Al-poly intensity: predicted values are compared with observed values and found to be consistent.

  11. Hosing instability in the blow-out regime for plasma-wakefield acceleration.

    PubMed

    Huang, C; Lu, W; Zhou, M; Clayton, C E; Joshi, C; Mori, W B; Muggli, P; Deng, S; Oz, E; Katsouleas, T; Hogan, M J; Blumenfeld, I; Decker, F J; Ischebeck, R; Iverson, R H; Kirby, N A; Walz, D

    2007-12-21

    The electron hosing instability in the blow-out regime of plasma-wakefield acceleration is investigated using a linear perturbation theory about the electron blow-out trajectory in Lu et al. [in Phys. Rev. Lett. 96, 165002 (2006)10.1103/PhysRevLett.96.165002]. The growth of the instability is found to be affected by the beam parameters unlike in the standard theory Whittum et al. [Phys. Rev. Lett. 67, 991 (1991)10.1103/PhysRevLett.67.991] which is strictly valid for preformed channels. Particle-in-cell simulations agree with this new theory, which predicts less hosing growth than found by the hosing theory of Whittum et al. PMID:18233526

  12. Simulation of scenarios of oil droplet formation from the Deepwater Horizon blowout.

    PubMed

    Zhao, Lin; Boufadel, Michel C; Adams, Eric; Socolofsky, Scott A; King, Thomas; Lee, Kenneth; Nedwed, Timothy

    2015-12-15

    Knowledge of the droplet size distribution (DSD) from the Deepwater Horizon (DWH) blowout is an important step in predicting the fate and transport of the released oil. Due to the absence of measurements of the DSD from the DWH incident, we considered herein hypothetical scenarios of releases that explore the realistic parameter space using a thoroughly calibrated DSD model, VDROP-J, and we attempted to provide bounds on the range of droplet sizes from the DWH blowout within 200 m of the wellhead. The scenarios include conditions without and with the presence of dispersants, different dispersant treatment efficiencies, live oil and dead oil properties, and varying oil flow rate, gas flow rate, and orifice diameter. The results, especially for dispersant-treated oil, are very different from recent modeling studies in the literature. PMID:26581815

  13. Methane emissions from the 2015 Aliso Canyon blowout in Los Angeles, CA.

    PubMed

    Conley, S; Franco, G; Faloona, I; Blake, D R; Peischl, J; Ryerson, T B

    2016-03-18

    Single-point failures of natural gas infrastructure can hamper methane emission control strategies designed to mitigate climate change. The 23 October 2015 blowout of a well connected to the Aliso Canyon underground storage facility in California resulted in a massive release of natural gas. Analysis of methane and ethane data from dozens of plume transects, collected during 13 research-aircraft flights between 7 November 2015 and 13 February 2016, shows atmospheric leak rates of up to 60 metric tons of methane and 4.5 metric tons of ethane per hour. At its peak, this blowout effectively doubled the methane emission rate of the entire Los Angeles basin and, in total, released 97,100 metric tons of methane to the atmosphere. PMID:26917596

  14. A MICRO CORONAL MASS EJECTION ASSOCIATED BLOWOUT EXTREME-ULTRAVIOLET JET

    SciTech Connect

    Hong Junchao; Jiang Yunchun; Zheng Ruisheng; Yang Jiayan; Bi Yi; Yang Bo

    2011-09-10

    The so-called mini coronal mass ejections (CMEs) were recently identified as small-scale eruptive events showing the same on-disk characteristics as large-scale CMEs, and Moore et al. further found that one-third of polar X-ray jets are the so-called blowout jets, in which the jet-base magnetic arch, often carrying a filament, undergoes a miniature version of the blowout eruptions that produce major CMEs. By means of the two viewpoint observations from the Solar Dynamics Observatory (SDO) and the Ahead of Solar Terrestrial Relations Observatory (STEREO A), in this Letter, we present the first observations that a blowout jet from the eruption of an EUV mini-filament channel in the quiet Sun was indeed associated with a real micro-CME. Captured by the on-disk SDO observations, the whole life of the mini-filament channel, from the formation to eruption, was associated with convergences and cancellations of opposite-polarity magnetic flux in the photosphere, and its eruption was accompanied by a small flare-like brightening, a small corona dimming, and posteruptive loops. The near-limb counterpart of the eruption observed by STEREO A, however, showed up as a small EUV jet followed by a white-light jet. These observations not only confirm the previous results that mini-filaments have characteristics common to large-scale ones, but also give clear evidences that blowout jets can result from the eruptions of mini-filaments and are associated with mini-CME.

  15. Mechanisms of Flame Stabilization and Blowout in a Reacting Turbulent Hydrogen Jet in Cross-Flow

    SciTech Connect

    Kolla, H.; Grout, R. W.; Gruber, A.; Chen, J. H.

    2012-08-01

    The mechanisms contributing to flame stabilization and blowout in a nitrogen-diluted hydrogen transverse jet in a turbulent boundary layer cross-flow (JICF) are investigated using three-dimensional direct numerical simulation (DNS) with detailed chemistry. Non-reacting JICF DNS were performed to understand the relative magnitude and physical location of low velocity regions on the leeward side of the fuel jet where a flame can potentially anchor. As the injection angle is reduced from 90{sup o} to 70{sup o}, the low velocity region was found to diminish significantly, both in terms of physical extent and magnitude, and hence, its ability to provide favorable conditions for flame anchoring and stabilization are greatly reduced. In the reacting JICF DNS a stable flame is observed for 90{sup o} injection angle and, on average, the flame root is in the vicinity of low velocity magnitude and stoichiometric mixture. When the injection angle is smoothly transitioned to 75{sup o} a transient flame blowout is observed. Ensemble averaged quantities on the flame base reveal two phases of the blowout characterized by a kinematic imbalance between flame propagation speed and flow normal velocity. In the first phase dominant flow structures repeatedly draw the flame base closer to the jet centerline resulting in richer-than-stoichiometric mixtures and high velocity magnitudes. In the second phase, in spite of low velocity magnitudes and a return to stoichiometry, due to jet bending and flame alignment normal to the cross-flow, the flow velocity normal to the flame base increases dramatically perpetuating the blowout.

  16. Airflow and sediment movement within an inland blowout in Hulun Buir sandy grassland, Inner Mongolia, China

    NASA Astrophysics Data System (ADS)

    Sun, Yu; Hasi, Eerdun; Liu, Meiping; Du, Huishi; Guan, Chao; Tao, Binbin

    2016-09-01

    We measured wind flows and sediment transport rates through a blowout in Hulun Buir grassland, Inner Mongolia. Topography and the angle of incidence between the approaching wind and the blowout long-axis significantly affected the air flow. Flow separated and decelerated at the western wall and accelerated towards the east, until maximum wind speed occurred at the top of the depositional lobe, and then decelerated on the lee side. When airflow emerged on the eastern wall, resultant directions were always NW. When winds approached from directions within 17.5° of the blowout axis, both the northwestern and southwestern walls developed turbulent flow, and significant topographic steering occurred. The deceleration zone expanded eastwards from 10.3 to 12.8 m from the western rim. When the wind direction was more oblique than 17.5°, turbulent flow at the southwestern wall disappeared. 'S-shaped' flow intensified, causing more pronounced steering at the bottom, but topographic steering elsewhere was reduced, and the boundary of the deceleration moved to 10 m from the western rim. Minor sediment deposition occurred on the western wall, while other parts were eroded; maximum sediment transport occurred at the top of the depositional lobe. The approaching wind speed affected the sediment transport rate more than the direction; and spatial variability in sediment transport reflected differences in compaction, vegetation coverage, slope, aspect, and upwind sediment availability, resulting in asymmetrical development. Overall, flow-form interactions governed the flow structures and controlled the evolution of the blowout via sediment transport.

  17. Blowout Jets: Hinode X-Ray Jets that Don't Fit the Standard Model

    NASA Technical Reports Server (NTRS)

    Moore, Ronald L.; Cirtain, Jonathan W.; Sterling, Alphonse C.; Falconer, David A.

    2010-01-01

    Nearly half of all H-alpha macrospicules in polar coronal holes appear to be miniature filament eruptions. This suggests that there is a large class of X-ray jets in which the jet-base magnetic arcade undergoes a blowout eruption as in a CME, instead of remaining static as in most solar X-ray jets, the standard jets that fit the model advocated by Shibata. Along with a cartoon depicting the standard model, we present a cartoon depicting the signatures expected of blowout jets in coronal X-ray images. From Hinode/XRT movies and STEREO/EUVI snapshots in polar coronal holes, we present examples of (1) X-ray jets that fit the standard model, and (2) X-ray jets that do not fit the standard model but do have features appropriate for blowout jets. These features are (1) a flare arcade inside the jet-base arcade in addition to the small flare arcade (bright point) outside that standard jets have, (2) a filament of cool (T is approximately 80,000K) plasma that erupts from the core of the jetbase arcade, and (3) an extra jet strand that should not be made by the reconnection for standard jets but could be made by reconnection between the ambient unipolar open field and the opposite-polarity leg of the filament-carrying flux-rope core field of the erupting jet-base arcade. We therefore infer that these non-standard jets are blowout jets, jets made by miniature versions of the sheared-core-arcade eruptions that make CMEs

  18. Tracking the Hercules 265 marine gas well blowout in the Gulf of Mexico

    NASA Astrophysics Data System (ADS)

    Romero, Isabel C.; Özgökmen, Tamay; Snyder, Susan; Schwing, Patrick; O'Malley, Bryan J.; Beron-Vera, Francisco J.; Olascoaga, Maria J.; Zhu, Ping; Ryan, Edward; Chen, Shuyi S.; Wetzel, Dana L.; Hollander, David; Murawski, Steven A.

    2016-01-01

    On 23 July 2013, a marine gas rig (Hercules 265) ignited in the northern Gulf of Mexico. The rig burned out of control for 2 days before being extinguished. We conducted a rapid-response sampling campaign near Hercules 265 after the fire to ascertain if sediments and fishes were polluted above earlier baseline levels. A surface drifter study confirmed that surface ocean water flowed to the southeast of the Hercules site, while the atmospheric plume generated by the blowout was in eastward direction. Sediment cores were collected to the SE of the rig at a distance of ˜0.2, 8, and 18 km using a multicorer, and demersal fishes were collected from ˜0.2 to 8 km SE of the rig using a longline (508 hooks). Recently deposited sediments document that only high molecular weight (HMW) polycyclic aromatic hydrocarbon (PAH) concentrations decreased with increasing distance from the rig suggesting higher pyrogenic inputs associated with the blowout. A similar trend was observed in the foraminifera Haynesina germanica, an indicator species of pollution. In red snapper bile, only HMW PAH metabolites increased in 2013 nearly double those from 2012. Both surface sediments and fish bile analyses suggest that, in the aftermath of the blowout, increased concentration of pyrogenically derived hydrocarbons was transported and deposited in the environment. This study further emphasizes the need for an ocean observing system and coordinated rapid-response efforts from an array of scientific disciplines to effectively assess environmental impacts resulting from accidental releases of oil contaminants.

  19. Evolution of bubble size distribution from gas blowout in shallow water

    NASA Astrophysics Data System (ADS)

    Zhao, Lin; Boufadel, Michel C.; Lee, Kenneth; King, Thomas; Loney, Norman; Geng, Xiaolong

    2016-03-01

    Gas is often emanated from the sea bed during a subsea oil and gas blowout. The size of a gas bubble changes due to gas dissolution in the ambient water and expansion as a result of a decrease in water pressure during the rise. It is important to understand the fate and transport of gas bubbles for the purpose of environmental and safety concerns. In this paper, we used the numerical model, VDROP-J to simulate gas formation in jet/plume upon release, and dissolution and expansion while bubble rising during a relatively shallow subsea gas blowout. The model predictions were an excellent match to the experimental data. Then a gas dissolution and expansion module was included in the VDROP-J model to predict the fate and transport of methane bubbles rising due to a blowout through a 0.10 m vertical orifice. The numerical results indicated that gas bubbles would increase the mixing energy in released jets, especially at small distances and large distances from the orifice. This means that models that predict the bubble size distribution (BSD) should account for this additional mixing energy. It was also found that only bubbles of certain sizes would reach the water surfaces; small bubbles dissolve fast in the water column, while the size of the large bubbles decreases. This resulted in a BSD that was bimodal near the orifice, and then became unimodal.

  20. Fractured Surface

    NASA Technical Reports Server (NTRS)

    2005-01-01

    [figure removed for brevity, see original site] Context image for PIA03084 Fractured Surface

    These fractures and graben are part of Gordii Fossae, a large region that has undergone stresses which have cracked the surface.

    Image information: VIS instrument. Latitude 16.6S, Longitude 234.3E. 18 meter/pixel resolution.

    Note: this THEMIS visual image has not been radiometrically nor geometrically calibrated for this preliminary release. An empirical correction has been performed to remove instrumental effects. A linear shift has been applied in the cross-track and down-track direction to approximate spacecraft and planetary motion. Fully calibrated and geometrically projected images will be released through the Planetary Data System in accordance with Project policies at a later time.

    NASA's Jet Propulsion Laboratory manages the 2001 Mars Odyssey mission for NASA's Office of Space Science, Washington, D.C. The Thermal Emission Imaging System (THEMIS) was developed by Arizona State University, Tempe, in collaboration with Raytheon Santa Barbara Remote Sensing. The THEMIS investigation is led by Dr. Philip Christensen at Arizona State University. Lockheed Martin Astronautics, Denver, is the prime contractor for the Odyssey project, and developed and built the orbiter. Mission operations are conducted jointly from Lockheed Martin and from JPL, a division of the California Institute of Technology in Pasadena.

  1. A small-scale eruption leading to a blowout macrospicule jet in an on-disk coronal hole

    SciTech Connect

    Adams, Mitzi; Sterling, Alphonse C.; Moore, Ronald L.; Gary, G. Allen E-mail: alphonse.sterling@nasa.gov E-mail: gag0002@uah.edu

    2014-03-01

    We examine the three-dimensional magnetic structure and dynamics of a solar EUV-macrospicule jet that occurred on 2011 February 27 in an on-disk coronal hole. The observations are from the Solar Dynamics Observatory (SDO) Atmospheric Imaging Assembly (AIA) and the SDO Helioseismic and Magnetic Imager (HMI). The observations reveal that in this event, closed-field-carrying cool absorbing plasma, as in an erupting mini-filament, erupted and opened, forming a blowout jet. Contrary to some jet models, there was no substantial recently emerged, closed, bipolar-magnetic field in the base of the jet. Instead, over several hours, flux convergence and cancellation at the polarity inversion line inside an evolved arcade in the base apparently destabilized the entire arcade, including its cool-plasma-carrying core field, to undergo a blowout eruption in the manner of many standard-sized, arcade-blowout eruptions that produce a flare and coronal mass ejection. Internal reconnection made bright 'flare' loops over the polarity inversion line inside the blowing-out arcade field, and external reconnection of the blowing-out arcade field with an ambient open field made longer and dimmer EUV loops on the outside of the blowing-out arcade. That the loops made by the external reconnection were much larger than the loops made by the internal reconnection makes this event a new variety of blowout jet, a variety not recognized in previous observations and models of blowout jets.

  2. Reliability Analysis of the Electrical Control System of Subsea Blowout Preventers Using Markov Models

    PubMed Central

    Liu, Zengkai; Liu, Yonghong; Cai, Baoping

    2014-01-01

    Reliability analysis of the electrical control system of a subsea blowout preventer (BOP) stack is carried out based on Markov method. For the subsea BOP electrical control system used in the current work, the 3-2-1-0 and 3-2-0 input voting schemes are available. The effects of the voting schemes on system performance are evaluated based on Markov models. In addition, the effects of failure rates of the modules and repair time on system reliability indices are also investigated. PMID:25409010

  3. Sea-floor methane blow-out and global firestorm at the K-T boundary

    USGS Publications Warehouse

    Max, M.D.; Dillon, William P.; Nishimura, C.; Hurdle, B.G.

    1999-01-01

    A previously unsuspected source of fuel for the global firestorm recorded by soot in the Cretaceous-Tertiary impact layer may have resided in methane gas associated with gas hydrate in the end-Cretaceous seafloor. End-Cretaceous impact-generated shock and megawaves would have had the potential to initiate worldwide oceanic methane gas blow-outs from these deposits. The methane would likely have ignited and incompletely combusted. This large burst of methane would have been followed by longer-term methane release as a part of a positive thermal feedback in the disturbed ocean-atmosphere system.

  4. Application of Petri nets to performance evaluation of subsea blowout preventer system.

    PubMed

    Liu, Zengkai; Liu, Yonghong; Cai, Baoping; Li, Xiaolei; Tian, Xiaojie

    2015-01-01

    This paper presents an application of deterministic and stochastic Petri nets (DSPN) to evaluate the performance of subsea blowout preventer (BOP) system. The overall subsea BOP system is comprised of five mechanical subsystems and five electrical subsystems, which can be viewed as a series-parallel system. In regard to common cause failures, TimeNET 4.0 toolkit is utilized to develop and analyze the DSPN models. Availability and reliability of the subsea BOP system and its subsystems are obtained. Besides, the effects of failure rate and repair time of each component on system performance are researched. PMID:25442402

  5. Life-threatening common carotid artery blowout: rescue treatment with a newly designed self-expanding covered nitinol stent.

    PubMed

    Kim, H S; Lee, D H; Kim, H J; Kim, S J; Kim, W; Kim, S Y; Suh, D C

    2006-03-01

    Carotid blowout is a devastating complication in patients with head and neck malignancy. A covered stent offers an alternative to treatment of a carotid blowout patient thought to be at high risk for surgery or carotid occlusion. Stent placement in the common carotid artery or carotid bulb is a technical challenge because of large luminal diameter and luminal calibre discrepancy between internal carotid artery and common carotid artery. We present four patients with common carotid rupture and massive bleeding who were treated with self-expanding covered stents, among them, two cases were treated with newly designed self-expanding polytetrafluoroethylene (PTFE)-covered nitinol stents. PMID:16498035

  6. The rise and fall of methanotrophy following a deepwater oil-well blowout

    NASA Astrophysics Data System (ADS)

    Crespo-Medina, M.; Meile, C. D.; Hunter, K. S.; Diercks, A.-R.; Asper, V. L.; Orphan, V. J.; Tavormina, P. L.; Nigro, L. M.; Battles, J. J.; Chanton, J. P.; Shiller, A. M.; Joung, D.-J.; Amon, R. M. W.; Bracco, A.; Montoya, J. P.; Villareal, T. A.; Wood, A. M.; Joye, S. B.

    2014-06-01

    The blowout of the Macondo oil well in the Gulf of Mexico in April 2010 injected up to 500,000 tonnes of natural gas, mainly methane, into the deep sea. Most of the methane released was thought to have been consumed by marine microbes between July and August 2010. Here, we report spatially extensive measurements of methane concentrations and oxidation rates in the nine months following the spill. We show that although gas-rich deepwater plumes were a short-lived feature, water column concentrations of methane remained above background levels throughout the rest of the year. Rates of microbial methane oxidation peaked in the deepwater plumes in May and early June, coincident with a rapid rise in the abundance of known and new methane-oxidizing microbes. At this time, rates of methane oxidation reached up to 5,900 nmol l-1 d-1--the highest rates documented in the global pelagic ocean before the blowout. Rates of methane oxidation fell to less than 50 nmol l-1 d-1 in late June, and continued to decline throughout the remainder of the year. We suggest the precipitous drop in methane consumption in late June, despite the persistence of methane in the water column, underscores the important role that physiological and environmental factors play in constraining the activity of methane-oxidizing bacteria in the Gulf of Mexico.

  7. Blow-out protector and fire control system for petroleum exploration

    SciTech Connect

    Caraway, M.F.; Caraway, B.L.

    1987-10-06

    A blow-out protector is described for an oil well comprising a housing having a vertical passageway therethrough for a Kelly. The housing has a lower end adapter flange to be connected to a well casing, an elastomeric body having an opening for the Kelly and carried on the Kelly for providing sealing contact with the Kelly and housing passageway, a catch ring secured to the Kelly and having a surface defined by a given diameter, a compressor ring plate positioned below the elastomeric body on the Kelly, means on an interior of the housing having a given diameter and preventing the compressor ring plate from falling down and yet providing engagement with the surface of the catch ring, the compressor ring plate having a hole for passage of the Kelly drive-mechanism for the drill pipe, the catch ring on the Kelly positioned below the compressor plate. The diameter of the catch ring is smaller than the diameter of the interior means on the housing so that when the Kelly is pulled up the catch ring will contact and force the compressor ring plate against the elastomeric body and force the elastomeric body into tight contact with both the Kelly and the housing thus sealing the space between the Kelly and the housing against a blow-out.

  8. Underwater Oil Plume Intrusion from Deepwater Blowouts - A Large-Eddy Simulation Study

    NASA Astrophysics Data System (ADS)

    Yang, D.; Chen, B.; Chamecki, M.; Meneveau, C. V.

    2015-12-01

    The interaction of buoyancy-driven hydrocarbon plumes with the stably stratified deep-ocean environment plays a crucial role in the formation of underwater oil intrusions. As gas bubbles and oil droplets are released from an underwater oil well blowout, they induce a strong buoyancy flux that lifts entrained sea water to form an upward plume. Towards higher elevations, the stratification-induced negative buoyancy increases and eventually exceeds the gas/oil-induced buoyancy, causing the plume to decelerate and a large fraction of entrained sea water to peel off from the rising plume to form a fountain-like downward outer plume. During this peeling process, weakly buoyant particles (e.g. small oil droplets) are trapped and fall together with the detrained fluid, and then migrate horizontally at the equilibrium buoyancy depth, forming underwater oil intrusion layers. In this study, the complex plume dynamics and oil intrusion are studied using a large-eddy simulation (LES) model. The LES model captures the essential characteristics of the plume structure and the peeling/intrusion processes, and yields good agreement with prior laboratory experiments. Applying to the Deepwater Horizon oil well blowout condition, the LES model shows considerable underwater trapping and intrusion of oil droplets under various conditions, with the trapping rate significantly affected by the diameter of the oil droplet. This study is supported by Gulf of Mexico Research Initiative RFP-II research grant.

  9. Lean blowout limits of a gas turbine combustor operated with aviation fuel and methane

    NASA Astrophysics Data System (ADS)

    Xiao, Wei; Huang, Yong

    2016-05-01

    Lean blowout (LBO) limits is critical to the operational performance of combustion systems in propulsion and power generation. The swirl cup plays an important role in flame stability and has been widely used in aviation engines. Therefore, the effects of swirl cup geometry and flow dynamics on LBO limits are significant. An experiment was conducted for studying the lean blowout limits of a single dome rectangular model combustor with swirl cups. Three types of swirl cup (dual-axial swirl cup, axial-radial swirl cup, dual-radial swirl cup) were employed in the experiment which was operated with aviation fuel (Jet A-1) and methane under the idle condition. Experimental results showed that, with using both Jet A-1 and methane, the LBO limits increase with the air flow of primary swirler for dual-radial swirl cup, while LBO limits decrease with the air flow of primary swirler for dual-axial swirl cup. In addition, LBO limits increase with the swirl intensity for three swirl cups. The experimental results also showed that the flow dynamics instead of atomization poses a significant influence on LBO limits. An improved semi-empirical correlation of experimental data was derived to predict the LBO limits for gas turbine combustors.

  10. Scientific Studies in Support of Shutting In the Macondo Well (Deepwater Horizon) Blowout, Gulf of Mexico (Invited)

    NASA Astrophysics Data System (ADS)

    Hickman, S.; Mooney, W. D.; Hsieh, P. A.; Enomoto, C.; Nelson, P. H.; McNutt, M.

    2010-12-01

    Scientists, engineers and managers from BP, other private companies, universities, government research labs and a broad spectrum of federal agencies have formed a unique cooperative working relationship in responding to the Macondo oil well (Deepwater Horizon) blowout. Among the many activities performed during this effort, U.S. Geological Survey personnel evaluated the potential geologic hazard of shutting in the Macondo well at the sea floor, and collectively decided, with others, the conditions under which it could be safely undertaken. These hazards included the possible loss of wellbore integrity under the anticipated high shut-in pressures, potentially leading to new pathways for hydrocarbon release to the Gulf of Mexico through upward hydraulic fracture propagation and/or soft sediment erosion initiating at possible leak points in the cemented casing. This hazard evaluation required analysis of 2D and 3D seismic surveys, seafloor bathymetry, pressure transient tests, geophysical well logs, in-situ stress (“leak-off”) tests and drilling data (e.g., mud logs) to assess the geological, hydrological and geomechanical conditions at and around the Macondo well. After the well was successfully capped and shut in by BP on July 15, a variety of monitoring practices were put into place to guard against further leaks into the Gulf. These monitoring activities included acquisition of wellhead pressure data, marine multi-channel seismic profiles, sea-floor and sea-surface sonar surveys (the latter using the NOAA RV/Pisces), and wellhead visual/acoustic monitoring. Scientists and engineers from BP, outside consultants, government agencies and the university community then worked together to continuously evaluate these data to ensure that the well remained safely shut in until reservoir pressures were suppressed (“killed”) with heavy drilling mud and the well was sealed with cement. This effort to shut in and then permanently seal the blown-out Macondo well has

  11. The persistence of large-scale blowouts in largely vegetated coastal dune fields

    NASA Astrophysics Data System (ADS)

    Delgado-Fernandez, Irene; Smyth, Thomas; Jackson, Derek; Davidson-Arnott, Robin; Smith, Alexander

    2016-04-01

    Coastal dunes move through natural phases of stability and instability during their evolution, displaying various temporal and spatial patterns across the dune field. Recent observations, however, have shown exceptionally rapid rates of stability through increased vegetative growth. This progressive vegetation colonisation and consequent loss of bare sand on coastal dune systems has been noted worldwide. Percentage reductions in bare sand of as much as 80% within just a few decades can been seen in examples from South Africa, Canada and Brazil as well as coastal dune sites across NW Europe. Despite these dramatic trends towards dune stabilisation, it is not uncommon to find particular examples of large-scale active blowouts and parabolic dunes within largely vegetated coastal dunes. While turbulence and airflow dynamics within features such as blowouts and other dune forms has been studied in detail within recent years, there is a lack of knowledge about what maintains dune mobility at these specific points in otherwise largely stabilized dune fields. This work explores the particular example of the 'Devil's Hole' blowout, Sefton Dunes, NW England. Approximately 300 m long by 100 m wide, its basin is below the water-table which leads to frequent flooding. Sefton Dunes in general have seen a dramatic loss of bare sand since the 1940s. However, and coinciding with this period of dune stabilisation, the 'Devil's Hole' has not only remained active but also grown in size at a rate of 4.5 m year-1 along its main axis. An exploration of factors controlling the maintenance of open bare sand areas at this particular location is examined using a variety of techniques including Computational Fluid Dynamics (CFD) airflow modelling and in situ empirical measurements of (short-term experiments) of wind turbulence and sand transport. Field measurements of wind parameters and transport processes were collected over a 2 week period during October 2015. Twenty three 3D ultrasonic

  12. Effects of Various Blowout Panel Configurations on the Structural Response of LANL Building 16-340 to Internal Explosions

    SciTech Connect

    Jason P. Wilke

    2005-09-30

    The risk of accidental detonation is present whenever any type of high explosives processing activity is performed. These activities are typically carried out indoors to protect processing equipment from the weather and to hide possibly secret processes from view. Often, highly strengthened reinforced concrete buildings are employed to house these activities. These buildings may incorporate several design features, including the use of lightweight frangible blowout panels, to help mitigate blast effects. These panels are used to construct walls that are durable enough to withstand the weather, but are of minimal weight to provide overpressure relief by quickly moving outwards and creating a vent area during an accidental explosion. In this study the behavior of blowout panels under various blast loading conditions was examined. External loadings from explosions occurring in nearby rooms were of primary interest. Several reinforcement systems were designed to help blowout panels resist failure from external blast loads while still allowing them to function as vents when subjected to internal explosions. The reinforcements were studied using two analytical techniques, yield-line analysis and modal analysis, and the hydrocode AUTODYN. A blowout panel reinforcement design was created that could prevent panels from being blown inward by external explosions. This design was found to increase the internal loading of the building by 20%, as compared with nonreinforced panels. Nonreinforced panels were found to increase the structural loads by 80% when compared to an open wall at the panel location.

  13. Geophysical and Geochemical Evidence For Methane Venting at Large Gas Blowouts Along the US Mid-Atlantic Shelf Edge

    NASA Astrophysics Data System (ADS)

    Newman, K. K.; Cormier, M.; Driscoll, N.; Hill, J.; Kastner, M.; Singh, H.; Weissel, J.

    2005-12-01

    Kilometer-scale, elongate gas blowouts are present at the edge of the North Carolina/Virginia continental shelf. We conducted a detailed survey in July 2004 to determine if fluids are venting at the blowouts site and to understand their origin. The Autonomous Underwater Vehicle (AUV) SeaBED collected underway data 3 m above the seafloor using a METS methane sensor, CTD and color digital camera. In addition, piston cores and hydrocasts were acquired for geochemical analysis of pore waters and the water column. Based on the AUV data, salinity and temperature exhibit a negative correlation with dissolved methane concentration. However, the raw METS measurements of dissolved methane lag behind the salinity and temperature anomalies, progressively ramping up or down compared to the impulse signal recorded for the salinity and temperature anomalies. This type of response is consistent with that expected for diffusion across a membrane, which is a characteristic of the METS sensor. Using the assumption that diffusion is responsible for the observed lag we calculated the time constant of the system to be approximately 11 minutes and used that to correct the instrument response function for the METS sensor. The corrected dissolved methane measurements show concentrations of 50-200 nM, values well above that of normal seawater (2-4 nM). Hydrocast water samples indicate methane maxima between 100 and 130 m with concentrations up to 43 nM. The positive anomalies, both from the AUV and hydrocast data, are concentrated on the upper parts of the blowout walls, extend westward onto the shelf and are observed up to 70 m depth in the water column. Methane anomalies are not generally present in the axes of the blowouts, suggesting that methane presently discharges along the blowout walls rather than through the floors. To determine if density driven stratification is present, and assuming that salinity and temperature are good proxies for methane concentration, we examined vertical

  14. Orbit to orbit transportation

    NASA Technical Reports Server (NTRS)

    Bergeron, R. P.

    1980-01-01

    Orbital transfer vehicle propulsion options for SPS include both chemical (COTV) and electrical (EOTV) options. The proposed EOTV construction method is similar to that of the SPS and, by the addition of a transmitting antenna, may serve as a demonstration or precursor satellite option. The results of the studies led to the selection of a single stage COTV for crew and priority cargo transfer. An EOTV concept is favored for cargo transfer because of the more favorable orbital burden factor over chemical systems. The gallium arsenide solar array is favored over the silicon array because of its self annealing characteristics of radiation damage encountered during multiple transitions through the Van Allen radiation belt. Transportation system operations are depicted. A heavy lift launch vehicle (HLLV) delivers cargo and propellants to LEO, which are transferred to a dedicated EOTV by means of an intraorbit transfer vehicle (IOTV) for subsequent transfer to GEO. The space shuttle is used for crew transfer from Earth to LEO. At the LEO base, the crew module is removed from the shuttle cargo bay and mated to a COTV for transfer to GEO. Upon arrival at GEO, the SPS construction cargo is transferred from the EOTV to the SPS construction base by IOTV. Crew consumables and resupply propellants are transported to GEO by the EOTV. Transportation requirements are dominated by the vast quantity of materials to be transported to LEO and GEO.

  15. Elbow Fractures

    MedlinePlus

    ... and held together with pins and wires or plates and screws. Fractures of the distal humerus (see ... doctor. These fractures usually require surgical repair with plates and/or screw, unless they are stable. SIGNS ...

  16. Olecranon Fractures.

    PubMed

    Brolin, Tyler J; Throckmorton, Thomas

    2015-11-01

    Olecranon fractures are common upper extremity injuries, with all but nondisplaced fractures treated surgically. There has been a recent shift in the surgical management of these fractures from tension band wiring to locking plate fixation and intramedullary nailing; however, this comes with increased implant cost. Although most patients can expect good outcomes after these various techniques, there is little information to guide a surgeon's treatment plan. This article reviews the epidemiology, classification, treatment, and outcomes of olecranon fractures. PMID:26498547

  17. Orbital cellulitis

    MedlinePlus

    ... Haemophilus influenzae B) vaccine. The bacteria Staphylococcus aureus , Streptococcus pneumoniae , and beta-hemolytic streptococci may also cause orbital cellulitis. Orbital cellulitis infections in children may get worse very quickly and can lead ...

  18. Orbital pseudotumor

    MedlinePlus

    ... Names Idiopathic orbital inflammatory syndrome (IOIS) Images Skull anatomy References Goodlick TA, Kay MD, Glaser JS, Tse DT, Chang WJ. Orbital disease and neuro-ophthalmology. In: Tasman W, Jaeger EA, eds. Duane’s ...

  19. Kepler's Orbit

    NASA Video Gallery

    Kepler does not orbit the Earth, rather it orbits the Sun in concert with the Earth, slowly drifting away from Earth. Every 61 Earth years, Kepler and Earth will pass by each other. Throughout the ...

  20. Patterns of Fracture and Tidal Stresses Due to Nonsynchronous Rotation: Implications for Fracturing on Europa

    NASA Technical Reports Server (NTRS)

    Parmentier, E. M.; Helfenstein, P.

    1985-01-01

    Global lineaments on Europa were interpreted as fractures in an icy crust. A variety of lineament types were identified, which appear to form a systematic pattern on the surface. For a synchronously rotating body, the patterns of fractures observed could be produced by a combination of stresses due to orbital recession, orbital eccentricity, and internal contraction. However, it was recently suggested that the forced eccentricity of Europa's orbit may result in nonsynchronous rotation. The hypothesis that fractures in a thin icy crust may have formed in response to stresses resulting from nonsynchronous rotation is studied.

  1. Sports fractures.

    PubMed Central

    DeCoster, T. A.; Stevens, M. A.; Albright, J. P.

    1994-01-01

    Fractures occur in athletes and dramatically influence performance during competitive and recreational activities. Fractures occur in athletes as the result of repetitive stress, acute sports-related trauma and trauma outside of athletics. The literature provides general guidelines for treatment as well as a variety of statistics on the epidemiology of fractures by sport and level of participation. Athletes are healthy and motivated patients, and have high expectations regarding their level of function. These qualities make them good surgical candidates. Although closed treatment methods are appropriate for most sports fractures, an aggressive approach to more complicated fractures employing current techniques may optimize their subsequent performance. PMID:7719781

  2. Fatal carotid blowout syndrome after BNCT for head and neck cancers.

    PubMed

    Aihara, T; Hiratsuka, J; Ishikawa, H; Kumada, H; Ohnishi, K; Kamitani, N; Suzuki, M; Sakurai, H; Harada, T

    2015-12-01

    Boron neutron capture therapy (BNCT) is high linear energy transfer (LET) radiation and tumor-selective radiation that does not cause serious damage to the surrounding normal tissues. BNCT might be effective and safe in patients with inoperable, locally advanced head and neck cancers, even those that recur at previously irradiated sites. However, carotid blowout syndrome (CBS) is a lethal complication resulting from malignant invasion of the carotid artery (CA); thus, the risk of CBS should be carefully assessed in patients with risk factors for CBS after BNCT. Thirty-three patients in our institution who underwent BNCT were analyzed. Two patients developed CBS and experienced widespread skin invasion and recurrence close to the carotid artery after irradiation. Careful attention should be paid to the occurrence of CBS if the tumor is located adjacent to the carotid artery. The presence of skin invasion from recurrent lesions after irradiation is an ominous sign of CBS onset and lethal consequences. PMID:26282568

  3. Formation dynamics of subsurface hydrocarbon intrusions following the Deepwater Horizon blowout

    USGS Publications Warehouse

    Socolofsky, Scott A.; Adams, E. Eric; Sherwood, Christopher R.

    2011-01-01

    Hydrocarbons released following the Deepwater Horizon (DH) blowout were found in deep, subsurface horizontal intrusions, yet there has been little discussion about how these intrusions formed. We have combined measured (or estimated) observations from the DH release with empirical relationships developed from previous lab experiments to identify the mechanisms responsible for intrusion formation and to characterize the DH plume. Results indicate that the intrusions originate from a stratification-dominated multiphase plume characterized by multiple subsurface intrusions containing dissolved gas and oil along with small droplets of liquid oil. Unlike earlier lab measurements, where the potential density in ambient water decreased linearly with elevation, at the DH site it varied quadratically. We have modified our method for estimating intrusion elevation under these conditions and the resulting estimates agree with observations that the majority of the hydrocarbons were found between 800 and 1200 m.

  4. Formation dynamics of subsurface hydrocarbon intrusions following the Deepwater Horizon blowout

    USGS Publications Warehouse

    Socolofsky, S.A.; Adams, E.E.; Sherwood, C.R.

    2011-01-01

    Hydrocarbons released following the Deepwater Horizon (DH) blowout were found in deep, subsurface horizontal intrusions, yet there has been little discussion about how these intrusions formed. We have combined measured (or estimated) observations from the DH release with empirical relationships developed from previous lab experiments to identify the mechanisms responsible for intrusion formation and to characterize the DH plume. Results indicate that the intrusions originate from a stratification-dominated multiphase plume characterized by multiple subsurface intrusions containing dissolved gas and oil along with small droplets of liquid oil. Unlike earlier lab measurements, where the potential density in ambient water decreased linearly with elevation, at the DH site it varied quadratically. We have modified our method for estimating intrusion elevation under these conditions and the resulting estimates agree with observations that the majority of the hydrocarbons were found between 800 and 1200 m. Copyright ?? 2011 by the American Geophysical Union.

  5. Sedimentary Biogeochemical Indicators for Assessing the Impacts of the Deepwater Horizon Blowout on Coastal Wetlands

    NASA Astrophysics Data System (ADS)

    McNeal, K. S.; Guthrie, C. L.; Mishra, D.

    2013-05-01

    The impact of the Deepwater Horizon blowout on coastal wetlands can be understood through investigating carbon loading and microbial activity in salt marsh sediments. Carbon influx causes porewater sulfide to increase in wetland sediment, making it toxic and inhospitable to marsh vegetation. High sulfide levels due to increased microbial activity can lead to plant browning and mortality. Preliminary analyses at Marsh Point, MS indicated that sulfate reducing bacteria are more active in contaminated grass, producing sulfide concentrations 100x higher than in non-contaminated grass. Sediment electrode profiles, hydrocarbon contamination, and microbial community profiles were measured at three additional locations to capture the spatial sedimentary geochemical processes impacting salt marsh dieback. Findings indicate that response to contamination is variable due to physical and biogeochemical processes specific to each marsh. Temporal evaluation indicates that there is a lag in maximum response to contamination due to seasonal effects on microbial activity.

  6. Risk of Carotid Blowout After Reirradiation of the Head and Neck: A Systematic Review

    SciTech Connect

    McDonald, Mark W.; Moore, Michael G.

    2012-03-01

    Purpose: Carotid blowout (CB) is a rare but frequently fatal complication of head-and-neck (H and N) cancer or its treatment. We sought to determine the reported rate of CB in patients receiving salvage reirradiation for H and N cancer. Methods and Materials: A literature search identified 27 published articles on H and N reirradiation involving 1554 patients, and a pooled analysis was performed to determine the rate of CB. Treatment parameters, including prior radiation dose, interval from prior radiation, dose and fractionation of reirradiation, use of salvage surgery, and chemotherapy, were abstracted and summarized. The cumulative risk of CB was compared between groups using Fisher's exact test. Results: Among 1554 patients receiving salvage H and N reirradiation, there were 41 reported CBs, for a rate of 2.6%; 76% were fatal. In patients treated in a continuous course with 1.8-2-Gy daily fractions or 1.2-Gy twice-daily fractions, 36% of whom received concurrent chemotherapy, the rate of CB was 1.3%, compared with 4.5% in patients treated with 1.5 Gy twice daily in alternating weeks or with delayed accelerated hyperfractionation, all of whom received concurrent chemotherapy (p = 0.002). There was no statistically significant difference in the rate of CB between patients treated with or without concurrent chemotherapy, or between patients treated with or without salvage surgery before reirradiation. Conclusion: Carotid blowout is an infrequent but serious complication of salvage reirradiation for H and N cancer. The rate of CB was lower among patients treated with conventional or hyperfractionated schedules compared with regimens of accelerated hyperfractionation, though heterogeneous patient populations and treatment parameters preclude definite conclusions. Given the high mortality rate of CB, discussion of the risk of CB is an important component of informed consent for salvage reirradiation.

  7. Novel Surgical Approaches to the Orbit

    PubMed Central

    Campbell, Ashley A.; Grob, Seanna R.; Yoon, Michael K.

    2015-01-01

    Determining safe surgical access to the orbit can be difficult given the complex anatomy and delicacy of the orbital structures. When considering biopsy or removal of an orbital tumor or repair of orbital fractures, careful planning is required to determine the ideal approach. Traditionally, this has at times necessitated invasive procedures with large incisions and extensive bone removal. The purpose of this review was to present newly techniques and devices in orbital surgery that have been reported over the past decade, with aims to provide better exposure and/or minimally invasive approaches and to improve morbidity and/or mortality. PMID:26692713

  8. Hip fracture - discharge

    MedlinePlus

    Inter-trochanteric fracture repair - discharge; Subtrochanteric fracture repair - discharge; Femoral neck fracture repair - discharge; Trochanteric fracture repair - discharge; Hip pinning surgery - discharge

  9. Experimental data regarding the characterization of the flame behavior near lean blowout in a non-premixed liquid fuel burner.

    PubMed

    De Giorgi, Maria Grazia; Sciolti, Aldebara; Campilongo, Stefano; Ficarella, Antonio

    2016-03-01

    The article presents the data related to the flame acquisitions in a liquid-fuel gas turbine derived burner operating in non-premixed mode under three different equivalence fuel/air ratio, which corresponds to a richer, an intermediate, and an ultra-lean condition, near lean blowout (LBO). The data were collected with two high speed visualization systems which acquired in the visible (VIS) and in the infrared (NIR) spectral region. Furthermore chemiluminescence measurements, which have been performed with a photomultiplier (PMT), equipped with an OH* filter, and gas exhaust measurements were also given. For each acquisition the data were related to operating parameters as pressure, temperature and equivalent fuel/air ratio. The data are related to the research article "Image processing for the characterization of flame stability in a non-premixed liquid fuel burner near lean blowout" in Aerospace Science and Technology [1]. PMID:26862557

  10. [Orbital inflammation].

    PubMed

    Mouriaux, F; Coffin-Pichonnet, S; Robert, P-Y; Abad, S; Martin-Silva, N

    2014-12-01

    Orbital inflammation is a generic term encompassing inflammatory pathologies affecting all structures within the orbit : anterior (involvement up to the posterior aspect of the globe), diffuse (involvement of intra- and/or extraconal fat), apical (involvement of the posterior orbit), myositis (involvement of only the extraocular muscles), dacryoadenitis (involvement of the lacrimal gland). We distinguish between specific inflammation and non-specific inflammation, commonly referred to as idiopathic inflammation. Specific orbital inflammation corresponds to a secondary localization of a "generalized" disease (systemic or auto-immune). Idiopathic orbital inflammation corresponds to uniquely orbital inflammation without generalized disease, and thus an unknown etiology. At the top of the differential diagnosis for specific or idiopathic orbital inflammation are malignant tumors, represented most commonly in the adult by lympho-proliferative syndromes and metastases. Treatment of specific orbital inflammation begins with treatment of the underlying disease. For idiopathic orbital inflammation, treatment (most often corticosteroids) is indicated above all in cases of visual loss due to optic neuropathy, in the presence of pain or oculomotor palsy. PMID:25455557