Soejima Kazutaka, Shimoda Katsumi, Kashimura Tsutomu, Yamaki Takashi, Kono Taro, Sakurai Hiroyuki, Nakazawa Hiroaki
Department of Plastic and Reconstructive Surgery, School of Medicine, Nihon University , Tokyo , Japan.
J Plast Surg Hand Surg. 2013 Oct;47(5):368-73. doi: 10.3109/2000656X.2013.769443. Epub 2013 May 28.
Although endoscopic transmaxillary repair of orbital floor fractures is a minimally invasive treatment, controversy remains regarding the method for supporting the orbital floor after elevation of the orbital contents. To date, a urethral balloon catheter has been widely used. However, it can be difficult to leave the catheter in place for a long time period due to the inconvenience, and prolapse of the orbital contents may recur in the case of its premature removal. This study described the techniques for endoscopic reduction and use of a balloon for orbital floor fractures. From June 2006 through November 2011, 30 of 52 patients (57.7%) with an isolated orbital floor fracture underwent endoscopic transmaxillary repair. A maxillary sinus balloon (#3007, Koken Co., Japan) was inserted into the maxillary sinus to support the orbital floor after endoscopic transmaxillary reduction, and the connecting tube of the balloon was pulled into the nasal cavity through the maxillary ostium. After confirmation of accurate reduction by postoperative CT, the connecting tube was shortened and hidden in the nasal cavity. The balloon was left in place for 4-8 weeks, and then removed via the maxillary ostium on an outpatient basis. Complete resolution of the preoperative diplopia was achieved in 93%, and no late-developing enophthalmos was seen in 97% of the patients. There were no significant complications. This technique is safe and permits prolonged retention of the balloon, without interfering with daily life.
尽管内镜经上颌窦修复眶底骨折是一种微创治疗方法，但对于眶内容物抬高后眶底的支撑方法仍存在争议。迄今为止，尿道球囊导管已被广泛使用。然而，由于不便，很难长时间留置导管，并且如果过早取出，眶内容物脱垂可能会复发。本研究描述了内镜下复位和使用球囊治疗眶底骨折的技术。从2006年6月至2011年11月，52例单纯眶底骨折患者中有30例（57.7%）接受了内镜经上颌窦修复。在内镜经上颌窦复位后，将一个上颌窦球囊（#3007，日本光研株式会社）插入上颌窦以支撑眶底，球囊的连接管通过上颌窦口拉入鼻腔。术后CT确认准确复位后，缩短连接管并藏于鼻腔内。球囊留置4 - 8周，然后在门诊经上颌窦口取出。93%的患者术前复视完全消失，97%的患者未出现晚期眼球内陷。无明显并发症。该技术安全，可使球囊长时间留置，且不影响日常生活。
