Kim Joo Yeon, Choi Gwan, Kwon Jae Hwan
Department of Otolaryngology-Head and Neck Surgery, Kosin University College of Medicine, Busan, Korea.
Clin Exp Otorhinolaryngol. 2015 Sep;8(3):250-5. doi: 10.3342/ceo.2015.8.3.250. Epub 2015 Aug 13.
The purpose of this study was to evaluate the advantages and limitations of using a silicon tube to support the fractured orbital floor by a transantral approach.
A retrospective study was conducted from January 2000 to December. 2011 in 51 patients with pure orbital floor fractures. The patients underwent reduction surgery via a transantral approach for inserting a folded silastic tube to support the fractured orbital floor in the maxillary sinus. A chart review of preoperative and postoperative ocular symptoms, operation records, and complications was maintained.
In 18 out of 25 patients with diplopia, postoperative improvement was seen. In 13 out of 15 patients with extraocular muscle limitation, postoperative improvement was seen. Enophthalmos resolved postoperatively in four of five patients. Postsurgical complications occurred in three patients: an overcorrection, an infection in the maxillary sinus, and an implant extrusion, all of which were resolved by revision surgeries.
During the course of the study, we sensed reduction using a folded silastic tube via a transantral approach as an easy and effective technique with good postoperative results, and minimal implant related complications. This novel procedure is recommended as a surgical option for the reduction of orbital floor fractures.
本研究的目的是评估经鼻窦途径使用硅胶管支撑眼眶底骨折的优缺点。
对2000年1月至2011年12月期间51例单纯眼眶底骨折患者进行回顾性研究。患者通过经鼻窦途径接受复位手术,插入折叠的硅橡胶管以支撑上颌窦内的眼眶底骨折。对术前和术后的眼部症状、手术记录及并发症进行图表回顾。
25例复视患者中有18例术后有改善。15例眼外肌受限患者中有13例术后有改善。5例眼球内陷患者中有4例术后得到解决。3例患者出现术后并发症:1例过度矫正、1例上颌窦感染和1例植入物挤出,所有这些均通过翻修手术得到解决。
在研究过程中,我们感觉到经鼻窦途径使用折叠的硅橡胶管进行复位是一种简单有效的技术,术后效果良好,且与植入物相关的并发症最少。推荐这种新方法作为眼眶底骨折复位的手术选择。