The Reconstruction of the Extensive Inferior Blow-out Fracture Through Endoscopic Transnasal and Subciliary Approaches

광범위한 안와하벽골절에서 속눈썹밑 절개 및 비강 내 내시경적 접근을 동시에 사용한 재건술

  • Cho, Soo-Jong (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Oh, Heung-Chan (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Nam, Su-Bong (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Kang, Cheol-Uk (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University) ;
  • Bae, Yong-Chan (Department of Plastic and Reconstructive Surgery, School of Medicine, Pusan National University)
  • 최수종 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 오흥찬 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 남수봉 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 강철욱 (부산대학교 의학전문대학원 성형외과학교실) ;
  • 배용찬 (부산대학교 의학전문대학원 성형외과학교실)
  • Received : 2009.07.15
  • Accepted : 2009.09.04
  • Published : 2009.11.10

Abstract

Purpose: Inferior blow-out fracture is the common facial fracture. Unsatisfactory functional and aesthetic outcomes are frequent when it is treated inappropriately. If fractures are extended and reach the posterior end of orbital floor, enophthalmos frequently followed as complication. The purpose of this study was to evaluate reduction technique of extensive inferior blow-out fracture with ballooning of foley catheter through endoscopic transnasal approach and implantation of $Medpor^{(R)}$ through subciliary approach. Methods: A retrospective study was performed on 14 patients with extensive inferior blow-out fracture who underwent ballooning of foley catheter through endoscopic transnasal approach with implantation of $Medpor^{(R)}$ through subciliary approach. Patients were operated from May 2005 to November 2007. Data for 14 patients were acquired from patient's charts. Preoperative and postoperative data for enophthalmos, diplopia, limitation of extraocular motion were reviewed. Preoperative and postoperative CT scan were also checked. The patients were followed up from 4 to 18 months. Results: The enophthalmos was corrected in all patients. Among 7 patients with diplopia preoperatively, diplopia was resolved in three patients postoperatively. The diplopia persisted in four patients and two of them also had limitation of extraocular motion postoperatively. The limitation of extraocular motion occurred in seven patients preoperatively. But five patients recovered after operation immediately. These symptoms were resolved about three months after the operation. Conclusion: The ballooning of foley catheter through endoscopic transnasal approach with implantation of $Medpor^{(R)}$ through subciliary approach can be considered one of the appropriate technique for extensive inferior blowout fracture.

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Acknowledgement

Supported by : 부산대학교