Comparison of Endoscopic Endonasal Reduction and Transcaruncular Reduction for the Treatment of Medial Orbital Wall Fractures
- 한기환; 최태현; 손대구; 김준형; 김상현
- Alternative Author(s)
- Han, Ki Hwan; Choi, Tae Hyun; Son, Dae Gu; Kim, Jun Hyung; Kim, Sang Hyon
- Issued Date
- Currently, endoscopic endonasal reduction and transcaruncular
reduction are frequently used as surgical treatments for medial orbital
wall fractures. However, these 2 surgical techniques have not been
comprehensively compared using objective criteria. Therefore, the results
of these 2 techniques were compared retrospectively using 8 objective
criteria in patients with medial orbital wall fracture.
This study included 48 medial orbital wall fracture patients treated from June
1993 to July 2006: 29 had endoscopic endonasal reduction and 19 had transcaruncular
reduction. Computed tomographic scans, double vision field testing for
diplopia using Goldmann perimetry, and Hertel exophthalmometer (Richmond
Products, Albuquerque, NM) were done pre- and postsurgery.
The average follow-up period was 70.8 months. Among patients with
pure medial orbital wall fractures, the average reduction rate was 89.2% for
the endoscopic endonasal reduction group and 90.7% for the transcaruncular
reduction group. One case in the endoscopic endonasal reduction group had
a more than 2-mm enophthalmos after surgery. The diplopia correction rate
was 1.8% in the endoscopic endonasal reduction group and 2.7% in the
transcaruncular reduction group. None of the above differences was statistically
significant. However, among patients with pure medial orbital wall
fractures compared with the transcaruncular reduction group, the average operation
time, the average hospital stay, and the average cost were significantly
greater in the endoscopic endonasal reduction group.
The 2 surgical methods had a similar effectiveness; however, transcaruncular
reduction seemed to be more advantageous with respect to
the operation time, the length of hospital stay, and cost.
Key Words: medial orbital wall fracture, endoscopic endonasal reduction,
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