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Advantage of Middle Meatal Antrostomy in Transnasal Endoscopic Reconstruction of Medial Orbital Blow-out Fracture  

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)
Publication Information
Archives of Plastic Surgery / v.34, no.6, 2007 , pp. 735-740 More about this Journal
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
Medial orbital wall fracture; Transnasal endoscopic reconstruction; Middle meatal antrostomy;
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1 Lee HM, Han SK, Chae SW, Hwang SJ, Lee SH: Endoscopic endonasal reconstruction of blowout fractures of the medial orbital walls. Plast Reconstr Surg 109: 872, 2002   DOI   ScienceOn
2 Park SW, Kim YH, Kwon JH, Cho JH: Endoscopic endonasal reconstruction of the medial orbital wall using a - shape 1 mm thick silastic sheet and filling with compressed $merocel^{\circledR}$. Korean J Otolaryngol-Head Neck Surg 47: 75, 2004
3 Stammberger H: Endoscopic endonasal surgeryconcepts in treatment of recurring rhinosinusitis. Part I. Anatomic and pathophysiologic considerations. Otolaryngol Head Neck Surg 94: 143, 1986   DOI
4 Jones DE, Evans JN: "Blow-out" fractures of the orbit. an investigation into their anatomical basis. J Laryngol Otol 81: 1109, 1967   DOI   ScienceOn
5 Iinuma T, Hirota Y, Ishio K: Orbital wall fractures. Conventional views and CT. Rhinology 32: 81, 1994
6 Lee MJ, Kang YS, Yang JY, Lee DY, Chung YY, Rohrich RJ: Endoscopic transnasal approach for the treatment of medial orbital blow-out fracture: a technique for controlling the fractured wall with a balloon catheter and $merocel^{\circledR}$ . Plast Reconstr Surg 110: 417, 2002   DOI   ScienceOn
7 Yamaguchi N, Arai S, Mitani H, Uchida Y: Endoscopic endonasal technique of the blowout fracture of the medial orbital wall. Operative Technique Otolaryngol Head Neck Surg 2: 269, 1991   DOI
8 Grove AS Jr, Tadmor R, New PF, Momose KJ: Orbital fracture evaluation by coronal computed tomography. Am J Ophthalmol 85: 679, 1978   DOI
9 Manson PN: Facial Injuries. In McCarthy JG(eds): Plastic Surgery. Philadelphia, W.B. Sounders company, 1990, p 1058
10 Mathog RH: Management of orbital blow-out fractures. Otolaryngol Clin North Am 24: 79, 1991
11 Jin HR, Shin SO, Choo MJ, Choi YS: Relationship between the extent of fracture and the degree of enophthalmos in isolated blowout fractures of the medial orbital wall. J Oral Maxillofac Surg 58: 617, 2000   DOI
12 Parsons GS, Mathog RH: Orbital wall and volume relationships. Arch Otolaryngol Head Neck Surg 114:743, 1988   DOI   ScienceOn
13 Albu S, Tomescu E: Small and large middle meatus antrostomies in the treatment of chronic maxillary sinusitis. Otolaryngol Head Neck Surg 131: 542, 2004   DOI   ScienceOn