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Transconjunctival Approach to Blow-out Fractures of Orbit in Children


Authors: K. Bartoňková;  I. Šlapák
Authors place of work: Dětská ORL klinika LF MU a FN Brno
Published in the journal: Otorinolaryngol Foniatr, 60, 2011, No. 4, pp. 218-222.
Category: Original Article

Summary

Introduction:
Blow-out fracture or hydraulic orbit fracture is a specific injury of the orbit. The blow-out fracture most often originates due to a blunt blow on the area of ocular bulb, often at traffic accidents, sports or blow to one’s head.

Materials and methods:
In the years 1994 – 2010, 27 patients with the blow-out orbit fracture diagnosis have been treated at the Child ORL Clinic, Medical Faculty (KDORL LF MU), Masaryk University and Faculty Hospital in Brno. The mean age of the patients was 9.5 years in the range of 5 to 18 years. All patients were examined by CT of the orbit or by NMR. The left side was affected in 19 patients, the right side in eight.

Results:
the surgery was performed in 21 patients. In 6 of them, where diplopia was not present or herniation of the orbit content into maxillary sinus was not proved, the authors used conservative treatment under careful observation. Surgical reposition of the simple blow-out fracture was performed by transconjunctival approach. In case of necessity a specially adapted plate of Zenoderm or Goretex was applied within the whole range of the defect. In two patients a revision surgery was necessary for persisting diplopia.

Conclusion:
The most favorable approach to reposition of hydraulic fracture is apparently the transconjunctival approach from the standpoint of view, procedure simplicity as well as the cosmetic outcome.

Key words:
blow-out orbital fractures, child patients, diplopia, transconjunctival approach.


Zdroje

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Štítky
Audiology Paediatric ENT ENT (Otorhinolaryngology)
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