Amin Julian D, Rizzi Christopher J, Trent Graham, Greywoode Jewel, Grumbine Lawson, Raghavan Prashant, Vakharia Kalpesh T
Department of Otorhinolaryngology-Head and Neck Surgery, University of Maryland, School of Medicine, Baltimore, MD.
Department of Internal Medicine, University of Lousiville, School of Medicine, Louisville, KY.
J Craniofac Surg. 2019 Oct;30(7):2277-2279. doi: 10.1097/SCS.0000000000005873.
To define a reliable and consistent landmark, the superior posterior wall of the maxillary sinus, and to describe how this landmark can be used when repairing orbital floor fractures.
Retrospective chart review. Patients >18 years old diagnosed with unilateral orbital floor and/or zygomaticomaxillary complex fractures.
The distance from the inferior orbital rim to the superior posterior wall of the maxillary sinus (landmark distance), and the distance from the landmark to the entrance of the optic canal were reported.
Eighty patients were included in the study. Each had unilateral isolated orbital floor fractures (n = 46) or unilateral zygomaticomaxillary complex fractures with an orbital floor component (n = 34). The contralateral eye in all patients was uninjured, and was used as an internal control. In orbital floor fractures, the mean landmark distance was 38.8 ± 1.4 mm, with a mean distance on the normal side of 38.8 ± 1.6 mm (P = 0.49). Distance to the optic canal on the injured side in isolated orbital floor fracture patients was 9.0 ± 0.8 mm with the same measurement on the normal side being 8.8 ± 0.7 (P = 0.21). In the setting of zygomaticomaxillary complex fracture, the orbital floor length was 38.2 ± 1.3 mm with a mean normal floor length of 37.8 ± 1.1 mm (P = 0.18). The mean distance from the superior posterior wall to optic canal in zygomaticomaxillary complex fractured orbits was 9.2 ± 1.1 mm with a normal side mean length of 9.5 ± 1.0 mm (P = 0.23). No significant difference was found between the measured distances in the fractured orbit and its normal counterpart for both fracture groups.
The superior posterior wall of the maxillary sinus is a reliable landmark that can be used to assist in placement of an orbital floor reconstructive plate. The landmark is unchanged despite the presence of an orbital floor or zygomaticomaxillary sinus fracture.
确定一个可靠且一致的标志，即上颌窦上后壁，并描述在修复眶底骨折时如何使用该标志。
回顾性病历审查。纳入年龄大于18岁、诊断为单侧眶底和/或颧上颌复合体骨折的患者。
报告眶下缘至上颌窦上后壁的距离（标志距离），以及该标志至视神经管入口的距离。
80例患者纳入研究。其中，单侧孤立性眶底骨折患者46例，单侧颧上颌复合体骨折合并眶底骨折患者34例。所有患者的对侧眼均未受伤，用作内部对照。在眶底骨折患者中，平均标志距离为38.8±1.4mm，正常侧平均距离为38.8±1.6mm（P=0.49）。孤立性眶底骨折患者患侧至视神经管的距离为9.0±0.8mm，正常侧相同测量值为8.8±0.7mm（P=0.21）。在颧上颌复合体骨折的情况下，眶底长度为38.2±1.3mm，正常眶底平均长度为37.8±1.1mm（P=0.18）。颧上颌复合体骨折眼眶中，上后壁至视神经管的平均距离为9.2±1.1mm，正常侧平均长度为9.5±1.0mm（P=0.23）。两个骨折组中，骨折眼眶与其正常对应眼眶的测量距离之间均未发现显著差异。
上颌窦上后壁是一个可靠的标志，可用于辅助眶底重建钢板的放置。无论是否存在眶底或颧上颌窦骨折，该标志均保持不变。
