Reduction of the Blowout Fracture of the Inferior Orbital Wall Using Elasticity of Silicon Tube

Moon, Jung Hwan; Park, Seong Won; Kim, Young Ho; Kwon, Min Sang; Han, Chang Yong; Kwon, Jae Hwan; Cho, Joong Hwan

Abstract

BACKGROUND AND OBJECTIVES
For the cases of the blowout fracture of the inferior orbital wall, reduction was performed frequently through transantral approach supporting herniated orbital tissue with silastic block, gauze or ureteral ballon catheter. But transantral approach has significant drawbacks such as instability, displacement of materials, and incomplete reduction. To overcome these shortcomings, we used an elastic silicon tube through transantral approach. In this paper, we compare the operative results between the group in which silastic blocks were used and the group in which silicon tubes were used. MATERIALS AND METHOD: We examined 19 patients whose maxillary sinuses were packed with silastic blocks or silicon tubes through only transantral approach. Among them, silastic blocks were used in nine cases ("block group") and silicon tubes in ten ("tube group"). Differences in preoperative and postoperative ocular symptoms, the percentage of revision operation, and occurrence of the infection of maxillary sinuses were compared between the two groups. RESULTS: In the block group, revision operations were carried out in three cases. Among those, one case was due to the undercorrection of fracture and two were due to the displacement of supporting material. In the tube group, one revision operation was necessary due to the overcorrection of fracture. Postoperative diplopia was observed in two cases among the block group and in one case among the tube group. One case with limitation in extraocular muscle movement was postoperatively detected among the block group. One case of infection of maxillary sinus was observed among the tube group. CONCLUSION: Reduction technique using silicone tube was easy and fast to perform by surgeons. We consider this reduction technique is a good surgical procedure instead of using silastic blocks.