Department of Orbital and Oculoplastic surgery, The Eye Hospital of Wenzhou Medical University, Wenzhou, Zhejiang, China.
Eye (Lond). 2021 Oct;35(10):2763-2770. doi: 10.1038/s41433-020-01304-0. Epub 2020 Nov 24.
To evaluate the safety, efficacy, and feasibility of an endoscopic transconjunctival inferior fornix and precaruncular approach for repair of combined orbital medial wall and floor fractures involving the inferomedial strut.
A retrospective study was performed in 84 patients with combined orbital medial wall and floor fractures involving the inferomedial strut. All patients underwent surgery by endoscopic transconjunctival inferior fornix and precaruncular approach. A large polyester mesh plate was implanted to cover the fracture defect. The enophthalmos, diplopia, and surgical complications were evaluated pre- and postoperatively. Patients were followed for at least 6 months.
A total of 84 patients (55 men and 29 women) with a mean age of 36.88 ± 12.95 years were included in this study. Preoperatively, all 84 patients had an enophthalmos >2 mm, and the mean exophthalmometry measurement was 11.6 ± 2.14 mm. Diplopia was presented in 33 patients. Postoperatively, good symmetry was acquired in 81 of 84 patients, with a mean improvement of 3.02 ± 0.99 mm in the enophthalmos (P < 0.05). Recovery from diplopia occurred in 32 of 33 patients. A new onset of diplopia occurred postoperatively in 13 of the remaining 51 patients, only to recover spontaneously after 1 month. One patient suffered retrobulbar hemorrhage after surgery and was cured by conservative therapy. No other serious complications occurred.
The endoscopic transconjunctival inferior fornix and precaruncular approach is a promising management technique for combined orbital medial wall and floor fractures involving the inferomedial strut.
评估经结膜下穹窿和内眦旁切口内镜治疗累及内下支柱的眶内侧壁和下壁合并骨折的安全性、有效性和可行性。
回顾性分析 84 例累及内下支柱的眶内侧壁和下壁合并骨折患者，所有患者均采用经结膜下穹窿和内眦旁切口内镜治疗，植入大型聚酯网板覆盖骨折缺损，评估术前和术后的眼球内陷、复视和手术并发症。患者至少随访 6 个月。
共纳入 84 例（55 例男性，29 例女性）患者，平均年龄 36.88±12.95 岁。术前所有 84 例患者均有>2mm 的眼球内陷，平均眼球突出度测量值为 11.6±2.14mm。33 例患者有复视。术后 84 例患者中有 81 例获得良好的对称性，眼球内陷平均改善 3.02±0.99mm（P<0.05）。33 例复视患者中有 32 例恢复。其余 51 例患者中有 13 例术后出现新发复视，1 个月后自发恢复。1 例患者术后发生球后血肿，经保守治疗治愈。无其他严重并发症发生。
经结膜下穹窿和内眦旁切口内镜治疗累及内下支柱的眶内侧壁和下壁合并骨折是一种有前途的治疗方法。
