Strong E Bradley, Kim Kenneth K, Diaz Rodney C
Department of Otolaryngology, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
Otolaryngol Head Neck Surg. 2004 Nov;131(5):683-95. doi: 10.1016/j.otohns.2004.05.017.
Transconjunctival and subciliary approaches to orbital floor blowout fractures (OBF) have known risks of postoperative eyelid malposition. This study evaluates the endoscopic transmaxillary repair of OBFs in a cadaveric model and clinical setting.
Sixteen cadaveric and 10 clinical OBFs were repaired endoscopically. A Caldwell-Luc approach and modified sinus surgery instrumentation were used to repair each fracture. Variations in fracture pattern, instrumentation, and surgical technique were evaluated.
Endoscopic repair was achieved in all 16 cadaveric orbits and in 9 of 10 patients. Fracture patterns were classified as either medial or lateral to the infraorbital nerve. Average clinical operating time was 1:38. Of 9 postoperative CT scans, 5 were rated as excellent, 3 as good, and 1 as poor.
The endoscopic transmaxillary approach is a safe, viable technique for OBF repair. It offers improved visualization, anatomic fracture repair, no risk of postoperative eyelid complications, and good clinical results.
C.
经结膜和睑缘下入路修复眶底爆裂性骨折（OBF）存在已知的术后眼睑位置异常风险。本研究在尸体模型和临床环境中评估内镜经上颌窦修复OBF。
对16例尸体和10例临床OBF进行内镜修复。采用柯-陆氏入路和改良鼻窦手术器械修复每例骨折。评估骨折类型、器械和手术技术的差异。
16个尸体眼眶和10例患者中的9例实现了内镜修复。骨折类型分为眶下神经内侧或外侧。平均临床手术时间为1小时38分钟。9例术后CT扫描中，5例评为优，3例评为良，1例评为差。
内镜经上颌窦入路是一种安全、可行的OBF修复技术。它提供了更好的视野、解剖复位、无术后眼睑并发症风险且临床效果良好。
C级
