Surgical treatment of patients with isolated fractures of orbit walls

Purpose is the optimization of surgical methods in patients with isolated orbital wall fractures.Patients and methods: for patients with isolated orbital wall fractures were used extraoral (n = 46) and infraaxillary (n = 66) surgical approaches. Abolition of defects and deformations using infraaxill...

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Main Authors: A. P. Bakushev, K. A. Sivolapov
Format: Article
Language:Russian
Published: Ophthalmology Publishing Group 2015-10-01
Series:Oftalʹmologiâ
Subjects:
Online Access:https://www.ophthalmojournal.com/opht/article/view/259
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author A. P. Bakushev
K. A. Sivolapov
author_facet A. P. Bakushev
K. A. Sivolapov
author_sort A. P. Bakushev
collection DOAJ
description Purpose is the optimization of surgical methods in patients with isolated orbital wall fractures.Patients and methods: for patients with isolated orbital wall fractures were used extraoral (n = 46) and infraaxillary (n = 66) surgical approaches. Abolition of defects and deformations using infraaxillary approach was made with a combined endoprosthesis which was developed in the Department of Oral and Maxillofacial Surgery in Novokuznetsk State Institute of Postgradu ate Medicine. The construction is a combination of L-shaped titanium mini-sheet and silicone slab.Results: during the observation the patients who underwent extraoral approaches (n = 46) we have diagnosed following complications: limit of the eyeball movement, diplopy (in case of using metal implants made of porous titanium nickelide and meshed titanium) — 3 (6,5 %) patients; — long-term lymphostas after surgery when using transconjunctive and subciliary approaches — 12 (26,1 %) patients; — ectropion when using infraorbital approach — 2 (4,3 %) patients; — moving of silicone implant with staying by infraorbital rim combined with enophthalmos as a late complication — 3 (6,5 %) patients. In group with infraaxillary approach (n = 66) there were no complications in early postoperative period. Late complications in 2‑6 months in the way of miniplate cutting were found in 5 (7,6 %) cases (in the area of inferior eyelid fold in the scar location), in 1 (1,5 %) cases — enophthalmos within 3 mm. While cutting the miniplate the implants were removed; then there were no any complications.Conclutions: in this study was determined infraaxillary approach was determined the effective method for reconstruction of orbital wall fractures as it removes post-traumatic enophthalmos, limitation of eyebulb movement, diplopy, eversion and lymphostasis of the lower eyelid. The use of infraaxillary approach allows to avoid all these comlications and to reach best clinical and functional results of patients treatment.
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spelling doaj.art-83e7a7b346324e9c9cb1f6923754f2c52023-03-13T09:08:36ZrusOphthalmology Publishing GroupOftalʹmologiâ1816-50952500-08452015-10-01123485310.18008/1816-5095-2015-3-48-53251Surgical treatment of patients with isolated fractures of orbit wallsA. P. Bakushev0K. A. Sivolapov1ГБОУДПО «Новокузнецкий государственный институт усовершенствования врачей» Министерства здравоохранения Российской Федерации, кафедра челюстно-лицевой хирургии и общей практики, ул.Строителей, 5, Новокузнецк, 654005, Российская ФедерацияГБОУДПО «Новокузнецкий государственный институт усовершенствования врачей» Министерства здравоохранения Российской Федерации, кафедра челюстно-лицевой хирургии и общей практики, ул.Строителей, 5, Новокузнецк, 654005, Российская ФедерацияPurpose is the optimization of surgical methods in patients with isolated orbital wall fractures.Patients and methods: for patients with isolated orbital wall fractures were used extraoral (n = 46) and infraaxillary (n = 66) surgical approaches. Abolition of defects and deformations using infraaxillary approach was made with a combined endoprosthesis which was developed in the Department of Oral and Maxillofacial Surgery in Novokuznetsk State Institute of Postgradu ate Medicine. The construction is a combination of L-shaped titanium mini-sheet and silicone slab.Results: during the observation the patients who underwent extraoral approaches (n = 46) we have diagnosed following complications: limit of the eyeball movement, diplopy (in case of using metal implants made of porous titanium nickelide and meshed titanium) — 3 (6,5 %) patients; — long-term lymphostas after surgery when using transconjunctive and subciliary approaches — 12 (26,1 %) patients; — ectropion when using infraorbital approach — 2 (4,3 %) patients; — moving of silicone implant with staying by infraorbital rim combined with enophthalmos as a late complication — 3 (6,5 %) patients. In group with infraaxillary approach (n = 66) there were no complications in early postoperative period. Late complications in 2‑6 months in the way of miniplate cutting were found in 5 (7,6 %) cases (in the area of inferior eyelid fold in the scar location), in 1 (1,5 %) cases — enophthalmos within 3 mm. While cutting the miniplate the implants were removed; then there were no any complications.Conclutions: in this study was determined infraaxillary approach was determined the effective method for reconstruction of orbital wall fractures as it removes post-traumatic enophthalmos, limitation of eyebulb movement, diplopy, eversion and lymphostasis of the lower eyelid. The use of infraaxillary approach allows to avoid all these comlications and to reach best clinical and functional results of patients treatment.https://www.ophthalmojournal.com/opht/article/view/259нижняя стенка глазницыэндопротезированиеспиральная компьютерная томографияпосттравматические дефекты и деформации
spellingShingle A. P. Bakushev
K. A. Sivolapov
Surgical treatment of patients with isolated fractures of orbit walls
Oftalʹmologiâ
нижняя стенка глазницы
эндопротезирование
спиральная компьютерная томография
посттравматические дефекты и деформации
title Surgical treatment of patients with isolated fractures of orbit walls
title_full Surgical treatment of patients with isolated fractures of orbit walls
title_fullStr Surgical treatment of patients with isolated fractures of orbit walls
title_full_unstemmed Surgical treatment of patients with isolated fractures of orbit walls
title_short Surgical treatment of patients with isolated fractures of orbit walls
title_sort surgical treatment of patients with isolated fractures of orbit walls
topic нижняя стенка глазницы
эндопротезирование
спиральная компьютерная томография
посттравматические дефекты и деформации
url https://www.ophthalmojournal.com/opht/article/view/259
work_keys_str_mv AT apbakushev surgicaltreatmentofpatientswithisolatedfracturesoforbitwalls
AT kasivolapov surgicaltreatmentofpatientswithisolatedfracturesoforbitwalls