Combination of transconjunctival and endonasal-transantral approach in the repair of blowout fractures involving the orbital floor

Kakibuchi, Masao; Fukazawa, Keijiro; Fukuda, Kenji; Yamada, Nahoko; Matsuda, Kazuo; Kawai, Kenichiro; Tomofuji, Seiichi; Sakagami, Masafumi

doi:10.1016/j.bjps.2003.10.006

Cited by 36 publications

(23 citation statements)

References 14 publications

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“…It may also reduce the risk of improper placement for experienced orbital surgeons who have no experience with navigation (PG). A common cause of inaccurate implant placement is the inability to define the posterior orbital ledge (Manson et al, 1986, Kakibuchi et al, 2004. In our study, none of the implants were positioned below the ledge, even in the traditional group.…”

Section: Comparison Of Traditional and Navigation Groupsmentioning

confidence: 60%

“…The complexity of orbital reconstruction in posttraumatic and post-ablative defects is well described in the published literature (Hammer, 1995 However, it may be difficult to locate the posterior ledge, which is the most important dorsal anatomical landmark and provides essential support for reconstruction material (Manson et al, 1986, Hammer, 1995, Kakibuchi et al, 2004. This is especially the case in a traumatized orbit with the combination of a comminuted fracture of the thin orbital floor and disrupted orbital soft tissue.…”

Section: Introductionmentioning

confidence: 92%

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Predictability in orbital reconstruction: A human cadaver study. Part II: Navigation-assisted orbital reconstruction

Dubois

Schreurs

Jansen

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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Preformed orbital reconstruction plates are useful for treating orbital defects. However, intraoperative errors can lead to misplaced implants and poor outcomes. Navigation-assisted surgery may help optimize orbital reconstruction. We aimed to explore whether navigation-assisted surgery is more predictable than traditional orbital reconstruction for optimal implant placement. Pre-injury computed tomography scans were obtained for 10 cadaver heads (20 orbits). Complex orbital fractures (Class III-IV) were created in all orbits, which were reconstructed using a transconjunctival approach with and without navigation. The best possible fit of the stereolithographic file of a preformed orbital mesh plate was used as the optimal position for reconstruction. The accuracy of the implant positions was evaluated using iPlan software. The consistency of orbital reconstruction was lower in the traditional reconstructions than in the navigation group in the parameters of translation and rotation. Implant position also differed significantly in the parameters of translation (p = 0.002) and rotation (pitch: p = 0.77; yaw: p < 0.001; roll: p = 0.001). Compared with traditional orbital reconstruction, navigation-assisted reconstruction provides more predictable anatomical reconstruction of complex orbital defects and significantly improves orbital implant position.

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Section: Comparison Of Traditional and Navigation Groupsmentioning

confidence: 60%

Section: Introductionmentioning

confidence: 92%

Predictability in orbital reconstruction: A human cadaver study. Part II: Navigation-assisted orbital reconstruction

Dubois

Schreurs

Jansen

et al. 2015

Journal of Cranio-Maxillofacial Surgery

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“…The surgical outcomes were poor due to inexact positioning of the orbital floor and in 18-60% of the cases in these reports, residual enophthalmos occurred. 6,10,[12][13][14]17,20 Nishiike et al evaluated endoscopic transantral insertion of antral bone grafts through the floor defect into the orbit, preventing lower eyelid injury with minimal donor site morbidity. 17 Lee et al reported that the quantity of maxillary bone is limited and lacks the bulk that can be provided by other autogenous bone donor sources.…”

Section: Discussionmentioning

confidence: 99%

“…The traditional approach exposes the orbital floor, but it is difficult to see the posterior edge of the fracture and the condition of the herniated tissue before and after reduction of the orbital contents. 13 Posterior dissection is the most difficult manoeuvre and is a common reason for failure of orbital floor repair.…”

mentioning

confidence: 99%

Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis

Hundepool

Willemsen

Wal

2012

International Journal of Oral and Maxillofacial Surgery

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“…12Y14 One technique is to use a traditional periorbital approach for the placement of an implant to reconstruct the orbital floor while placing an endoscope in the maxillary sinus to confirm the proper placement of that implant. 15 Chen and Chen 16 and Nahlieli et al 17 have advocated the use of mesh that is placed through a Caldwell-Luc approach of the anterior maxillary sinus and securing this in place with screws that are anchored within the maxillary sinus. Other authors have advocated the placement of an orbital floor implant using this same CaldwellLuc approach and then pushing the implant into the orbit to span the orbital defect.…”

mentioning

confidence: 99%

Endoscopic Approach to Maxillofacial Trauma

Schubert

Jenabzadeh

2009

Journal of Craniofacial Surgery

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Endoscopic approaches to maxillofacial trauma have included their use in temporomandibular joint arthroscopy, zygomatic arch repair, repair after orbital trauma, repair of frontal sinus fractures, and finally in the repair of subcondylar mandibular fractures. These techniques provide exciting new options for the management of facial fractures. Many of the techniques provide a steep learning curve and require specialized equipment. The approach to an orbital blowout fracture allows the use of a Caldwell-Luc approach and the use of a naturally occurring body space (the maxillary sinus) for the visualization and maneuvering of the endoscope, tools, and implants. The use of the endoscope in the management of fractures for facial structures such as mandibular subcondylar fractures, which do not have a naturally occurring body cavity, may present greater challenges when trying to obtain visualization, reduction, and fixation. When used for the treatment of subcondylar fractures, wide exposure and the use of right-angled drills and screw drivers may significantly help with this procedure. This may be considered by some surgeons as an endoscopically "assisted" procedure that can possibly be accomplished with direct visualization and the use of dental mirrors. It remains to be seen as to whether some of these diverse endoscopic applications will represent the standard of care in the future or remain a specialized technique practiced by a minority of surgeons in a few specialized centers. This article reviews various endoscopic applications to maxillofacial trauma and discusses some of the controversies of these techniques.

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Combination of transconjunctival and endonasal-transantral approach in the repair of blowout fractures involving the orbital floor

Cited by 36 publications

References 14 publications

Predictability in orbital reconstruction: A human cadaver study. Part II: Navigation-assisted orbital reconstruction

Predictability in orbital reconstruction: A human cadaver study. Part II: Navigation-assisted orbital reconstruction

Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis

Endoscopic Approach to Maxillofacial Trauma

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