Rodriguez Javier, Galan Ramon, Forteza Gabriel, Mateos Mario, Mommsen Jens, Bouso Olga Vazquez, Piera Veronica
Craniomaxillofac Trauma Reconstr. 2009 Mar;2(1):35-40. doi: 10.1055/s-0029-1202598.
The fracture of the medial orbital wall is relatively common in orbital trauma. Titanium mesh is possibly the actual standard material for orbital wall reconstruction. When the floor of the orbit and the medial wall are simultaneously affected, one larger mesh gives better results than two independent meshes that need to be fixated independently. However, large meshes need a wider surgical field. To gain sufficient exposure to the medial and inferior orbital walls simultaneously, we present an approach that combines the transconjunctival and transcaruncular incisions, detaching if needed the inferior oblique muscle and, placing our mesh, repositioning it beside the lacrimal duct. This technique should not entirely displace traditional approaches, but it widens the surgical exposure for middle- and upper-third facial trauma. This alternative has minimum morbidity and can save a great deal of surgery time.
眼眶内侧壁骨折在眼眶外伤中较为常见。钛网可能是眼眶壁重建的实际标准材料。当眶底和内侧壁同时受累时，一块较大的钛网比两块需要单独固定的独立钛网效果更好。然而，大尺寸钛网需要更宽的手术视野。为了同时充分暴露眼眶内侧壁和下壁，我们提出一种联合经结膜和经泪阜切口的方法，必要时分离下斜肌，放置钛网，并将其重新定位在泪道旁。该技术不应完全取代传统方法，但它拓宽了中面部和上三分之一面部创伤的手术视野。这种替代方法发病率最低，还能节省大量手术时间。
