Clinical Choice of surgical approach in the treatment of orbital floor fracture

Abstract

Objective To study the clinical choice of surgical approach in the treatment of orbital floor fracture. Methods 37 patients with orbital floor fracture were divided into 3 groups by the site of fracture and received 3 surgical approach include incision under the eyelashes ( 13 case) ,through the maxillary sinus ( 17 cases) ,or both two surgical approach (7 cases). To compare the degree of proptosis,ocular motility forced retraction test,diplopia before and after surgery. Results 37 patients had vertical diplopia, abnormal eye vertical movement, positive forced retration test ( to pull the eye upword with resistance), and the difference in degree of proptosis more than 4mm in 29 case,2 -4mm in 8 cases before surgery. After the surgery,all the patients had negtive forced retraction test ( to pull the eye upword with no resistance)and less than 2mm in the difference of proptosis' degree. All 13 cases in incision under the eyelashes group and 12 cases in through the maxillary sinus grpup recovered in eye movement and diplopia. 5 cases in through the maxillary sinus group and all 7 cases in the joint surgery group had underaction of ocular movement and diplopia on downgaze. Conclusion To choice different surgical approach in the treatment of orbital floor fracture,good healing effect could be available. Key words: Orbital floor fracture; Surgical approach; Healing effect