Department of Otorhinolaryngology, Japanese Red Cross Asahikawa Hospital, Asahikawa City, Hokkaido, Japan.
Department of Otorhinolaryngology, Sapporo Medical University School of Medicine, Sapporo City, Hokkaido, Japan.
Eur Arch Otorhinolaryngol. 2024 Nov;281(11):5807-5814. doi: 10.1007/s00405-024-08808-5. Epub 2024 Jul 31.
No definitive procedures have been proposed for orbital floor fractures extending to the slope of the posterior end, which is a challenging problem. This study demonstrates the effectiveness of an orbital reconstruction procedure based on anatomical landmarks that we developed, called the three landmarks procedure (TLP).
This study is a single-center retrospective cohort study conducted by the Department of Otorhinolaryngology, Japanese Red Cross Asahikawa Hospital. Data were collected from April 2000 to December 2023. The effect of TLP and the balloon procedure (BP) on ocular movement was compared. The prevalence of postoperative enophthalmos after TLP was examined.
The study included 17 patients who underwent TLP and 25 patients who underwent BP. Postoperative mean Hess area ratio (HAR%) was 98.3 (95% confidence interval (CI), 97.0-99.6) in the TLP group and 88.6 (95% CI 83.2-94.0) in the BP group. Among study patients with fractures extending to the posterior slope, 14 underwent TLP and 16 underwent BP. Postoperative mean HAR% was 98.5 (95% CI 97.3-99.7) in the TLP group and 89.2 (95% CI 82.4-95.8) in the BP group. Among all patients who underwent TLP, mean postoperative enophthalmos was 0.06 mm (95% CI - 0.32 to 0.44). It was 0.14 mm (95% CI - 0.31 to 0.59) among patients with fractures extending to the posterior slope.
TLP resulted in better postoperative ocular movements than BP. Furthermore, TLP is an effective technique for treating fractures extending to the posterior slope, which are challenging to reconstruct.
对于延伸到后端斜坡的眶底骨折，目前尚无明确的治疗方法，这是一个具有挑战性的问题。本研究展示了我们开发的一种基于解剖学标志的眶重建程序，即三个标志程序（TLP）的有效性。
这是一项由日本红十字旭川医院耳鼻喉科进行的单中心回顾性队列研究。数据收集时间为 2000 年 4 月至 2023 年 12 月。比较了 TLP 和球囊程序（BP）对眼球运动的影响。检查了 TLP 后发生术后眼球内陷的患病率。
研究包括 17 例接受 TLP 和 25 例接受 BP 的患者。TLP 组术后平均 Hess 面积比（HAR%）为 98.3（95%置信区间（CI）97.0-99.6），BP 组为 88.6（95% CI 83.2-94.0）。在延伸至后斜坡的骨折患者中，14 例接受 TLP，16 例接受 BP。TLP 组术后平均 HAR%为 98.5（95% CI 97.3-99.7），BP 组为 89.2（95% CI 82.4-95.8）。所有接受 TLP 的患者中，术后平均眼球内陷为 0.06 毫米（95% CI-0.32 至 0.44）。对于延伸至后斜坡的骨折患者，为 0.14 毫米（95% CI-0.31 至 0.59）。
TLP 术后眼球运动优于 BP。此外，TLP 是治疗具有挑战性的延伸到后端斜坡的骨折的有效技术。
