CT Navigation in Retromarginal (blow-out) Fractures of Eye-Socket Base
Authors:
D. Kovář 1,2; Z. Voldřich 1; P. Voska 1; P. Fundová 1; M. Navara 1
Authors‘ workplace:
ORL klinika 3. LF UK a ÚVN Praha
; přednosta kliniky MUDr. M. Navara, Ph. D.
Katedra válečné chirurgie FVZ UO Hradec Králové
1; vedoucí katedry doc. MUDr. L. Klein, CSc.
2
Published in:
Otorinolaryngol Foniatr, 61, 2012, No. 3, pp. 190-194.
Category:
Original Article
Overview
One of possible application s of CT navigated surgery in the ORL region is traumatology of facial skeleton.
CT navigation in this area makes it possible to the surgeon to use the navigation probe for evaluation of the extent and quality of performed reposition and fixation of the fracture, here specifically the eye-socket base. The procedure is based on preoperative CT VDN images with sections 1.5 – 2.0mm and subsequent registration. At our workplace surgery was performed for 28 blow-out fractures of eye-socket base in the period of 2007 – 2011. In 21 cases we used the transantral approach (8 times with CT navigation) and 7 times from the subciliary approach (under navigation in all cases). In the transantral approach the fractures were supported by a prop composed from a hydro plate and super acrylate lamina with a steel spiral. In the subciliary approach we used PMR splint six times and a PDS splint once. The proportion of men and women was 19:9 and the representation of sides was 15 on the left and 13 in case of the right eye socket. The mean age at the time of surgery was 41 years (16-85). The reposition was performed on day 3 up to 57 after the injury (day 12 on the average). In the analysis of our cohort we paid attention to comparing anatomical and functional results of surgically treated eye-socket base fractures in relation to surgical technique and the use of CT navigation. We evaluated the postoperative placement, position, eyeball motility and the state of diplopia.
In the group of primary interventions without CT navigation from transantral approach, diplopia disappeared in 77% of patients completely and in 23% operated on fracture of an older date the diplopia continues only in the outside positions of visual field and is considered as clinically insignificant.
In all surgically treated patients with CT navigation we reached a complete disappearance of diplopia and the correct position of the eyeball irrespective of the way of approach or the used fixation material.
Key words:
traumatology, CT navigation, fractures of eye-socket base, transantral approach.
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Audiology Paediatric ENT ENT (Otorhinolaryngology)Article was published in
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