Thumu Sai Kumar, Vura Nandagopal, Gaddipati Rajasekhar, Suvvada Bharathi
Department of Oral and Maxillofacial Surgery, Mamata Dental College, GiriPrasad nagar, Khammam, Telangana 507002 India.
J Maxillofac Oral Surg. 2022 Sep;21(3):911-915. doi: 10.1007/s12663-021-01566-5. Epub 2021 Apr 27.
The aim of our study was to evaluate the feasibility of an intraoral approach in the management of infraorbital rim fracture.
A total of 12 patients of which four were female and five were male with isolated unilateral zygomaticomaxillary complex (ZMC) fractures, essentially involving the infraorbital foramen (right or left), were included in this study. Indications for surgical intervention were cosmetic deformity, disturbance of vision, persistent paresthesia, or impaired mandibular movement. All the patients were subjected to thorough preoperative evaluation. A three-point fixation was performed in all the patients. Various parameters such as time required for exposure and the amount of accessibility were assessed intraoperatively, while the stability of the fixation and paresthesia pertaining to the distribution of the infraorbital nerve were assessed postoperatively.
A total of 12 patients with a mean age of 35.75 ± 12.7 years were included in the study. The mean time recorded for exposure and fixation was 21.33 ± 2.8 min. The accessibility was rated as "excellent" in 92% (11 patients) of the operated cases and rated "satisfactory" in 8% (1 patient) of the operated cases. The fixation was found to be stable in 100% of the cases. By the end of 8 months, normal mechanoreceptor response was elicited in 42% (five patients) of the cases and normal nocireceptor response was elicited in 92% (11 patients) of the cases.
The intraoral approach for fixation of the infraorbital rim is versatile and can be mastered even by novice surgeons. The virtual lack of complications and short learning curve make this approach an invincible modus operandi in a surgeon's repertoire.
本研究的目的是评估经口内入路治疗眶下缘骨折的可行性。
本研究纳入了12例患者，其中4例女性，5例男性，均为单侧孤立性颧上颌复合体（ZMC）骨折，主要累及眶下孔（右侧或左侧）。手术干预的指征为美容畸形、视力障碍、持续性感觉异常或下颌运动受限。所有患者均接受了全面的术前评估。所有患者均采用三点固定。术中评估暴露所需时间和可及性等各种参数，术后评估固定的稳定性以及与眶下神经分布相关的感觉异常。
本研究共纳入12例患者，平均年龄35.75±12.7岁。记录的暴露和固定平均时间为21.33±2.8分钟。92%（11例）的手术病例可及性评为“优秀”，8%（1例）的手术病例可及性评为“满意”。100%的病例固定稳定。到8个月末，42%（5例）的病例引出正常的机械感受器反应，92%（11例）的病例引出正常的伤害感受器反应。
眶下缘固定的经口内入路用途广泛，即使是新手外科医生也能掌握。几乎没有并发症且学习曲线短，使这种入路成为外科医生全部技能中不可战胜的手术方式。
