결막 절개를 통한 안저 골절의 정복

Abstract

A blow-out fracture is caused by the application of a traumatic force to the rim of the soft tissues of the orbit accompanied by a sudden increase in intraorbital pressure. The most common site of fracture of the orbital floor is the portion of the floor that is weakened by the infraorbital canal or groove. The surgical treatment of the blow-out fracture has three goals ; (1) To disengage entrapped structures and restore occulorotatory functions, (2) To replace orbital contents into the usual confines of the bony orbital cavity, (3) To restore orbital cavity size and volume, and replace the tissues into their proper position. Although various types of incision have been employed to approach the orbital floor, subciliary approach and conjunctival approach are most commonly used. The conjunctival incision avoids an external scar. Authors surgically intervened seven patients with pure or impure blow-out fractures through transconjunctival approach and then a thick silastic sheet was placed on the orbital floor for the prevention of relapse of the orbital contents not leaving conspicuous scars or major complications. The transconjunctival approach permits to avoid perforating the septum orbitale with a consequent extrusion of orbital fat, as well provides asthetic and functional results without conspicuous scar in management of blow-out fractures.