안와 외향골절 정복술에서 치료성적 및 술후 합병증 분석

Abstract

Background and Objectives：There has been a recent surge in the frequency of blowout fracture operations in the Departmentof Otorhinolaryngology. Clinical symptoms and signs, operative timing and the results from fracture site and size have been researchedin this study. We conducted this study to examine the postoperative complications causing re-operation in orbital blowoutfracture repair in the last seven years. Subjects and Method：Based on patients’ clinical data, we retrospectively reviewed160 patients who had operation because of blowout fracture from January 1998 to December 2004. Fifty-two patients had orbitalfloor, 74 patients had medial orbital wall, 34 patients had a combination of orbital floor and medial orbital wall fractures. We investigateddiplopia, limitation of eye movements, and enophthalmos after the surgery, and analyzed the frequency and causes ofre-operation. The mean postoperative follow-up was 24 months. Results：We classified complications into immediate complicationswhich occurred within 24 hours, late complications which occurred between 24 hours and 2 weeks, and delayed complicationswhich occurred 2 weeks or more after operation. The symptoms of complications included diplopia, EOM limitation,cheek hypoesthesia, loss of vision, oroantral fistula, implant infection, ectropion, and etc. In case of sequelae which lasted morethan six months, the combination of orbital floor and medial orbital wall fractures was higher than other fracture types. We carriedout re-operation on 14 cases and the main cause was incomplete reduction. Conclusion：Surgeons should perform properoperation according to fracture site and type, and insert the implant after making an adequate dissection in order to reduce thefrequency of complication and re-operation. (Korean J Otolaryngol 2006;49:802-6)