Archives of Plastic Surgery

Korean Society of Plastic and Reconstructive Surgeons (대한성형외과학회)
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Advantage of Middle Meatal Antrostomy in Transnasal Endoscopic Reconstruction of Medial Orbital Blow-out Fracture

안와내벽외향골절의 비내시경적정복술에 있어 중비도상악동절개술의 장점

  • Kim, Soon Heum (Department of Plastic and Reconstructive Surgery, College of Medicine, Konkuk University) ;
  • Lee, Soo Hyang (Department of Plastic and Reconstructive Surgery, College of Medicine, Konkuk University) ;
  • Choi, Hyun Gon (Department of Plastic and Reconstructive Surgery, College of Medicine, Konkuk University) ;
  • Shin, Dong Hyeok (Department of Plastic and Reconstructive Surgery, College of Medicine, Konkuk University) ;
  • Uhm, Ki Il (Department of Plastic and Reconstructive Surgery, College of Medicine, Konkuk University) ;
  • Kim, Bo Hyung (Department of Otolaryngology, College of Medicine, Konkuk University)
  • 김순흠 (건국대학교 의학전문대학원 성형외과학교실) ;
  • 이수향 (건국대학교 의학전문대학원 성형외과학교실) ;
  • 최현곤 (건국대학교 의학전문대학원 성형외과학교실) ;
  • 신동혁 (건국대학교 의학전문대학원 성형외과학교실) ;
  • 엄기일 (건국대학교 의학전문대학원 성형외과학교실) ;
  • 김보형 (건국대학교 의학전문대학원 이비인후과학교실)
  • Received : 2007.05.28
  • Published : 2007.11.10
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Abstract

Purpose: Blowout fracture is an outward fracture of the orbital wall. That usually occurs at inferior or medial wall of the orbit. The main pathophysiology is high intraocular pressure derived from impact of trauma. Among the four orbital wall, the medial wall is thinnest and most vulnerable to trauma. Many kinds of methods were introduced for correction of medial orbital wall fracture. Recently, transnasal endoscopic reconstruction methods were widely used. Endoscopic methods had many advantages. However, we experienced some cases of postoperative maxillary sinusitis. This study was planned to find out the effectiveness of middle meatal antrostomy after endoscopic reconstruction of medial orbital wall fracture. Methods: This study was retrospective analysis of 28 patients who underwent transnasal endoscopic repair of medial orbital wall fracture. The 18 male and 10 female patients were ranged from 17 to 57 years of age(mean, 30.9 years). Among 28 patients, randomly selected 17 patients underwent middle meatal antrostomy as additional procedure by the same surgeon. After at least 12 months of follow-up period, we examined the nasal symptom, endoscopic and CT findings. Results: One patient complained of nasal obstruction in middle meatal antrostomy group and four patients complained nasal symptoms in non middle meatal antrostomy group. On the endoscopic findings, three patients of non middle meatal antrostomy group had continuous nasal discharge. But middle meatal antrostomy group had no abnormal endoscopic findings. The abnormal CT finding(abnormal mucosal hypertrophy) were detected in four patient of non middle meatal antrostomy group. There were no abnormal CT findings in middle meatal antrostomy group. The data were statistically significant at comparative study. Conclusion: Authors think that the middle meatal antrostomy has some advantages as a additional procedure of endoscopic reconstruction of medial orbital wall fracture. Especially, it is good at preventing postoperative maxillary sinusitis. But, more larger group and strict application of disease entity are need for correct evaluation of middle meatal antrostomy effect.

Keywords

References

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