Clinical Study on Blowout Fractures of the Medial Orbital Wall Reconstructed by Bulla Ethmoidalis Osteomucosal Flap

Jo, Hyung Cheol; Kim, Sung Yun; Kang, Mu Hyun; Jang, Min Hee; Kwak, Hi Boong; Baik, Jun; Lee, Jong Won; Choi, Jung Seob

Abstract

BACKGROUND AND OBJECTIVES: Various surgical approaches have been employed to treat fractures of the medial orbital wall. Among them, the transnasal endoscopic approach provides the chance to avoid external scars and to observe the fracture site clearly. These approaches mostly require the use of grafts or splints. Authors carried out a retrospective study on the blowout fractures repaired by bulla ethmoidalis osteomucosal flap (BOMF) and compared them with the groups that were treated with silastic sheet only and with Med-pore(R) registered to investigate the merits of BOMF with respect to results and complications.
SUBJECTS AND METHOD
We reviewed 62 cases (64 sides) of medial wall fractures that were treated surgically. They were diagnosed with 3 mm facial CT scans and treated according to the authors' indications from February 1998 to March 2004 at Namgwang Hospital, Seonam University. The surgical treatment consisted of the reconstruction of the fractures and the repair of the remaining bone defects by graft and splint, and the type of graft was selected according to the size of the defect. For minor defects, silastic sheet was used alone, whereas major defects were repaired with BOMF or Med-pore(R) registered. All patients were evaluated regularly for at least six months postoperatively.
RESULTS
There were no differences in the aspects of the final treatment results of diplopia and enopthalmos. But in the aspects of postoperative crust formation and granulation, the cases that were repaired with BOMF showed better results as well as the economic merits. In the BOMF cases, the average duration of silastic sheet stenting was 12.5 days and it could reduce the follow up period.
CONCLUSION
BOMF demonstrated better results in the respects of duration of silastic sheet stenting, postope-rative crust formation, granulation and economic cost.