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Anales de Otorrinolaringología Mexicana

2018, Number 1

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Otorrinolaringología 2018; 63 (1)

Surgical mesh for the treatment of blowout fractures of the orbital floor wall with meatotomy under nasoendoscopy

García-Callejo FJ, Cebreros C, Redondo-Martínez J, Marqués M, Montoro-Elena MJ

Language: Spanish
References: 25
Page: 22-31
PDF size: 329.57 Kb.


ABSTRACT

Objective: To assess the usefulness of nasoendoscopic meatotomy without access as an alternative to the treatment of blowout fractures in the orbital floor.
Material and Method: A review was carried out as a series of cases underwent to reconstruction of the orbital floor wall fracture between December 2008 and December 2016, using a Marlex® polipropilene mesh adapted on the damaged area performing an endoscopic meatotomy. Degree of enophtalmus and ocular motility were considered conditioning factors to consider the endoscopic way as valid technique to repair these fractures.
Results: From all patients attended by facial trauma (n = 677), those with no fracture reached the 58%. On the middle third of facial bones, we detected 25 cases affecting the nasoethmoidal area and interesting the orbital walls, excluding type II and III LeFort fractures. Among the first ones, we decided to proceed in 11 cases with a meatotomy to locate the bone defect inside the maxillary sinus and push the orbital content upwards. Diplopia, exophthalmos and alterations in the ocular angle were present in the 91, 73 and 45%, respectively. Under nasoendoscopic surgery, an overall of absolute recovery was detected in all of them 14 days after. There was no significative bleeding related. The hospital staying ranged from three to ten days, excepting a case with brain oedema, which needed no additional surgery.
Conclusions: Marlex® lamina adapting by nasoendoscopic surgery is a good option to isolate orbital floor wall, because of its lack of external aggression and high biological integration ability with no risk of severe swelling or infection.


REFERENCES

  1. Burres SA, Cohn AM, Mathog RH. Repair of orbital blowout fractures with Marlex mesh and Gelfilm. Laryngoscope 1981 Nov;91(11):1881-6.

  2. Neovius E, Engstrand, T. Craniofacial reconstruction with bone and biomaterials: Review over the last 11 years. J Plast Reconstr Aesthet Surg 2010 Oct;63(10):1615-23. doi: 10.1016/j.bjps.2009.06.003.

  3. Gosse EM, Ferguson AW, Lymburn EG, Gilmour C, MacEwen CJ. Blow-out fractures: Patterns of ocular motility and effect of surgical repair. Br J Oral Maxillofac Surg 2010 Jan;48(1):40-3. doi: 10.1016/j.bjoms.2009.04.028.

  4. Yew CC, Shaari R, Rahman SA, Alam MK. White-eyed blowout fracture: Diagnostic pitfalls and review of literature. Injury 2015 Sep; 46(9):1856-9.

  5. San Vicente B, Parri FJ, Sancho MA, Morales L. Fracturas del suelo de la órbita. Cir Pediatr 2000;13:73-76.

  6. Liu SR, Song XF, Li ZK, Shen Q, Fan XQ. Postoperative improvement of diplopia and extraocular muscle movement in patients with reconstructive surgeries for orbital floor fractures. J Craniofac Surg 2016 Oct; 27: 2043-2049.

  7. Scolozzi P. Reconstruction of severe medial orbital wall fractures using titanium mesh plates placed using transcaruncular-transconjunctival approach: a successful combination of 2 techniques. J Oral Maxillofac Surg 2011 May;69(5):1415-20.

  8. Forrest LA, Schuller DE, Strauss RH. Management of orbital blowout fractures. Case reports and discussion. Am J Sports Med 1989;17:217-20.

  9. Lim NK, Kang DH, Oh SA, Gu JH. Orbital wall restoring surgery for inferomedial blowout fracture. J Craniofac Surg 2015 Nov;26(8):761-5.

  10. Nagasao T, Miyamoto J, Shimizu Y, Jiang H, Nakajima T. What happens between pure hydraulic and buckling mechanisms of blowout fractures? J Cranio-Maxillo-Facial Surg 2010 Jun;38(4):306-13.

  11. Sugamata A, Yoshizawa N. A case of blowout fracture of the orbital floor in early childhood. Int Med Case Rep J 2015 Jul;27(8):155-8.

  12. García-Rozado GA. Traumatología del complejo frontonaso- órbito-etmoidal: Estado actual, manejo terapéutico y revisión de 15 años de experiencia. Rev Esp Cir Oral Maxilfac 1998;20(6):303-21.

  13. Nam SM, Kim YB, Shin HS, Park ES. Orbital floor reconstruction considering orbital floor slope. J Craniofac Surg 2011 Jul;22(4):1479-82. doi: 10.1097/SCS.0b013e31821d19b3.

  14. Bande CR, Daware S, Lambade P, Patle B. Reconstruction of orbital floor fractures with autogenous bone graft application from anterior wall of maxillary sinus: a retrospective study. J Maxillofac Oral Surg 2015 Sep;14(3):605-10.

  15. Ozel B, Findikcioglu K, Sezgin B, Guney K, Barut I, Ozmen S. A new option for the reconstruction of orbital floor defects with heterologous cortical bone. J Craniomaxillofac Surg 2015 Oct;43(8):1583-8.

  16. Waite PD, Carr DD. The transconjuntival approach for treating orbital trauma. J Oral Maxillofac Surg 1991 May;49(5):499-503.

  17. Scapini DA, Mathog RH. Repair of orbital floor fractures with Marlex Mesh. Laryngoscope 1989 Jul;99(7Pt 1):697- 701.

  18. De Conto F, Eidt JM, Donaduzzi L, Ribeiro JD, Sawazaki R. Uso de malla de Marlex en el tratamiento de fracturas de suelo de órbita. Rev Chil Cir 2014 Jun;66(3):254-8.

  19. Oliveira RB, Silveira RL, Machado RA, Nascimento MMM. Utilização de diferentes materiais de reconstrução em fraturas de assoalho de órbita: relato de 6 casos. Rev Cir Traumatol Buco-Maxilo-Fac 2005 Jul-Sep;5(3):43-50.

  20. Martins TH, Bonardi JP, Stabile GA, Dallazen E, Hochuli- Vieira E, Pereira-Stabile CL. Management of blowout fracture with support of video endoscopy in a pediatric patient. J Craniofac Surg 2017 Jan;28(1):170-171.

  21. Kim JY, Choi G, Kwon JH. Transantral orbital floor fracture repair using a folded silastic tube. Clin Exp Otorhinolaryngol 2015 Sep;8(3):250-255.

  22. Park IH, Lee HM, Yanagi K. Endoscopic transantral and transnasal repair of orbital floor fracture with the ballooning technique, and classification and characterization of orbital floor fractures. Am J Rhinol Allergy 2015 Nov-Dec;29(6):445-8.

  23. Cantudo CM, Horno UF. Mallas quirúrgicas: clasificación, selección e implantación de un sistema de gestión. Panorama actual del Medicamento (PAM) 2015;382:334-337.

  24. Guitart P. Utilización de malla de polietileno (Marlex®) en la reparación de defectos de tejido de cavidades orgánicas. Cinco casos clínicos. Clínica Veterinaria de Pequeños Animales 1991 Ene-Mar;11(1):48-58.

  25. Park J, Yang S, Lee J, et al. Endoscopic reconstruction of isolated orbital floor wall fracture considering orbital floor slope. J Craniofac Surg 2016 Jun;27(4): 340-343.




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