TREATMENT OF PATIENTS WITH ISOLATED ORBITAL WALL INJURIES

Abstract

Objective: to optimize surgical treatment in patients with orbital wall defects and deformities. Material and methods. For diagnosis of orbital wall injuries, the patients underwent facial skeletal X-ray study in the semiaxial projection and midfacial spiral computed tomography. Defects were removed via the intrasinus approach in the victims, by applying a combined prosthesis designed at the Department of Oral Surgery and General Dentistry, Novokuznetsk State Institute for Postgraduate Training of Physicians. The design is a combination of a Г-shaped titanium miniplate and a silicone block. Results. Continuity of the inferior orbital wall was restored through the intrasinus approach in all cases (n = 82). There were no early postoperative complications. Late (at 3–6 months postsurgery) complications as the cutting and obvious contouring of a miniplate (in the area of the mucogingival fold at the surgical site) were stated in 6 (7.3%) cases. Enophthalmos was found in 2 (2.4%) cases. During miniplate cutting, the endoprostheses were removed and no other complications were observed during 1-to-3-year follow-ups. The paper describes a clinical case of a female patient with a blowout fracture of the left inferior orbital wall and dislocation of the orbital contents. Computer tomography (CT) findings were used to make a combined endoprosthesis; an inferior orbital wall defect was eliminated via the intrasinus approach. Control CT showed a complete elimination of orbital contents dislocation and restoration of the continuity of the inferior orbital wall. Conclusion. The given clinical case demonstrate that it is necessary to perform spiral CT at all stages of treatment and rehabilitation and it is expedient to apply the intrasinus approach to eliminating orbital wall defects and deformities.

Keywords

• inferior orbital wall
• endoprosthesis replacement
• spiral computed tomography
• posttraumatic defects and deformities