Department of Oral and Maxillofacial Plastic Surgery, Tuebingen University Hospital, Osianderstrasse 2-8, 72076 Tuebingen, Germany.
J Craniomaxillofac Surg. 2013 Dec;41(8):797-802. doi: 10.1016/j.jcms.2013.01.029. Epub 2013 Mar 1.
The treatment of complex orbital floor fractures with extensive orbital prolapse remains a surgical challenge in craniomaxillofacial traumatology and is still controversially discussed. Reduction of orbital tissue via a transcutaneous or transconjunctival approach alone can be very difficult and lead to unsatisfying results.
Over a 3-year-period, we enrolled 13 patients who underwent endoscopy-assisted reconstruction of isolated orbital floor fractures via a combined subciliary and transantral approach. Patient data, imaging and ophthalmologic examination were reviewed prospectively.
Ten patients underwent primary surgical treatment, 3 patients had secondary surgical treatment because of unsatisfactory results of primary surgical intervention. All patients had an uneventful postoperative course without ophthalmologic deterioration, no further surgical procedures were necessary.
The additional use of an endoscopy-assisted transantral approach provides a reliable treatment modality in selected cases. To our knowledge, this is the only study of patients treated with a combined subciliary and transantral approach. Special emphasis was given to postoperative functional results, a short algorithm for use of an additional transantral endoscopy-assisted approach is presented.
在颅面外伤学中，对于广泛眶内容脱垂的复杂眶底骨折的治疗仍然是一个手术挑战，目前仍存在争议。单独通过经皮或经结膜入路复位眶组织可能非常困难，并导致不满意的结果。
在 3 年期间，我们纳入了 13 名接受经眶下联合经蝶窦入路内镜辅助重建单纯眶底骨折的患者。前瞻性地回顾了患者数据、影像学和眼科检查结果。
10 名患者接受了初次手术治疗，3 名患者因初次手术干预效果不满意而接受了二次手术治疗。所有患者术后均无眼部恶化，无进一步手术治疗。
在选择的病例中，附加使用内镜辅助经蝶窦入路是一种可靠的治疗方法。据我们所知，这是唯一一项使用经眶下和经蝶窦联合入路治疗患者的研究。特别强调了术后功能结果，提出了一种附加使用经蝶窦内镜辅助入路的简短算法。
