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Type: Journal article
Title: Endoscopic transethmoidal and transconjunctival inferior Fornix approaches for repairing the combined medial wall and orbital floor blowout fractures
Author: Wu, Wencan
Yan, Wentao
Cannon, Paul S.
Jiang, Alice C.
Citation: Journal of Craniofacial Surgery, 2011; 22(2):537-542
Publisher: Lippincott Williams & Wilkins
Issue Date: 2011
ISSN: 1049-2275
School/Discipline: School of Medicine : Opthalmology & Visual Sciences
Statement of
Wencan Wu, Wentao Yan, Paul S. Cannon and Alice C. Jiang
Abstract: Purpose: To assess the combination of an endoscopic transethmoidal approach (ETEA) and a transconjunctival inferior fornix approach (TIFA) for repairing combined orbital floor and medial wall blowout fractures (COF-MWBOFs). Methods: Patients with unilateral COF-MWBOFs were randomized to 2 groups: ETEA combined with TIFA or medial canthal incision (MCI) combined with TIFA. Thin porous polyethylene sheets were implanted to cover the orbital defects. The postoperative follow-up time was 6 months. For both groups, degree of diplopia, enophthalmos, ocular motility, and complications were recorded and compared. Results: Our study included 32 patients in the ETEA group and 27 patients in the MCI group. The time from trauma to surgery ranged from 10 to 48 days. The herniated orbital contents were completely reduced in 96.9% (31/32) of the ETEA group and in 77.8% (21/27) of the MCI group (P = 0.040). At the 6-month review, the success rate of enophthalmos correction in the ETEA group achieved 96% (24/25), higher than that in the MCI group (66.7%, 12/18; P = 0.015). The improvement of the enophthalmos was better in the ETEA group than in the MCI group (4.5 ± 0.7 mm versus 3.2 ± 1.2 mm) at 6 months (P = 0.000). We found no difference in the resolution rate of diplopia within a 30-degree visual field or extraocular muscle function between the 2 groups. Complications in the MCI group included 1 patient with optic neuropathy after the procedure and 4 patients with medial canthal webbing. Conclusions: Endoscopic transethmoidal approach combined with TIFA is a promising technique for repairing extensive COF-MWBOFs.
Keywords: Combined orbital floor and medial wall blowout fractures; endoscopic transethmoidal approach; transconjunctival inferior fornix approach
Rights: © 2011 Mutaz B. Habal, MD
RMID: 0020104373
DOI: 10.1097/SCS.0b013e318207f478
Appears in Collections:Opthalmology & Visual Sciences publications

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