A simple technique for the treatment of inferior orbital blow-out fracture: a transantral approach, open reduction, and internal fixation with miniplate and screws.
OBJECTIVE
Infraorbital blow-out fracture (IOBF) is an uncommon midfacial trauma, and impairs eyeball function and causes esthetic problems. The extraoral approach can lead to some complications such as scarring, ectropion, and entropion. The intraoral approach, such as a transantral approach, has advantages such as no visible scaring, it can be used to simultaneously treat a zygomaticomaxillary complex fracture (ZMCF), and the procedure is relatively easy.


METHODS
IOBFs were reduced from the maxillary sinus, and fixated internally using miniplates and screws with/without Medpor (Porex, Newnan, GA) via a transantral approach. We used this technique in 11 patients who had an inferior blow-out fracture. Patient's records and CT scans were reviewed.


RESULTS
The mean age of the patients was 37 years (ranging between 15 years and 68 years). The mean follow-up period was 9.8 months, which ranged from 1 to 24 months. Before the operation, the patients had orbital symptoms: diplopia in 3 patients; enophthalmos in 4; and gaze limitation in 3. All the patients showed periorbital swelling and ecchymosis. After surgery, none of the patients had diplopia, gaze limitations, and enophthalmos. There were no orbital symptoms or sinus symptoms due to an infection or allergic reaction after surgery except in 1 patient. In 1 patient, maxillary sinusitis developed at 4 months after surgery which subsided with antibiotic therapy after plate removal.


CONCLUSIONS
We think this technique offers an easy approach, and produces reliable, satisfactory results in IOBF.
Kim
Jae-Hyung
JH
Dental Science Research Institute, Chonnam University, Gwangiu, Republic of Korea.
Kook
Min-Suk
MS
Ryu
Sun-Youl
SY
Oh
Hee-Kyun
HK
Park
Hong-Ju
HJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D009917:Orbital Fractures / Q000150:complications / Q000473:pathology / Q000601:surgery*; D020273:Orbital Implants; D055815:Young Adult; D015051:Zygomatic Fractures / Q000150:complications / Q000601:surgery