War-related facial trauma in Ukraine: Oculoplastic implications of shockwave and shrapnel injuries.
Author: Vladimir Kratky
Base Hospital / Institution: 1st Medical Faculty, Charles University, Prague
Rapid fire oral presentation
Abstract ID: 24-361
Purpose
Eye trauma is estimated to account for 20 per cent of all injuries in modern warfare. Due to widespread bombing and shelling in Ukraine, there are many patients with extensive facial injuries, including loss of eyes, and eyelid and orbital deformities. This is a summary overview of a recent mission to Ukraine by the charitable Face-the-Future Foundation with a multispecialty facial surgical team, including an oculoplastic surgeon.
Methods
A retrospective case series review demonstrating facial injuries as a result of explosions with shockwave and shrapnel trauma. The design and application of patient specific implants (PSI) in this population will be described. Review of wartime facial injury literature will be discussed.
Results
Several sample cases of orbital and midface trauma will be presented, including pre- and post-op photographs. Most common relevant surgical techniques and the design and implantation of PSI’s will also be covered. With respect to the orbital region, the most common secondary deformities included traumatic telecanthus, hypovolemic/contracted anophthalmic sockets and traumatic eyelid malpositions. In addition, lagophthalmos with severe exposure was commonly found in traumatic VII nerve palsies.
Conclusion
This presentation will demonstrate the type and extent of injuries to the orbital area and facial region from shockwave and shrapnel trauma, which is most commonly seen in wartime. There a distinct and unique pattern of damage, which is different from injuries in the general peacetime population. Patient Specific Implants play an important role in the reconstruction of complex skull fractures.
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