Enoftalminin düzeltilmesi için alternatif bir yaklaşım: Derin lateral orbita girişlimi

Year 2006, Volume: 16 Issue: 4, 189 - 192, 27.08.2006

Burçak Tümerdem İsmail Kuran

Abstract

Orbita tabanı kırıklarından sonra yetersiz kemik re- konstrüksiyonuna bağlı orbita volümünde artış enoftal- miye yol açabilir. Enoftalmi için bir diğer neden ise or- bita volüm kaybıdır. Geçirdiği travma ve bunu izleyen üç ameliyat sonrası orbita çevresi deformiteleri nede- niyle başvuran 33 yaşındaki kadın hastanın muayene- sinde, enoftalmi, vertikal yönde distopi ve “lateral scle- ral show” deformitesi saptandı. Birinci seansta kraniyal kemik grefti ile orbita tabanı güçlendirilerek vertikal dis- topi düzeltildi. Enoftalminin istenen ölçülerde düzelme- mesi nedeniyle derin lateral orbital duvar yaklaşımı kullanılarak orbita volümü artırıldı. Ameliyat sonrası dönemde, buz tatbiki ile kontrol altına alınan ödem dı- şında hastanın herhangi bir yakınması olmadı

Keywords

Enoftalmi/cerrahi, gözkapağı/cerrahi, orbital kırık/cerrahi, protez ve implant.

An alternative method for the correction of enophthalmos: deep lateral orbital approach

Abstract

Both increased orbital volüme due to inadequate orbital floor reconstruction and loss of orbital volüme may result in enophthalmos. Enophthalmos, vertical dystopia, and “lateral scleral show” deformity were detected in a 33-year-old female patient who pre- sented with periorbital deformities after three opera- tions for the correction of traumatic zygomatic frac- ture. First, vertical dystopia was repaired by rein- forcing the orbital base with cranial bone grafting.Since enophthalmos was not successfully corrected, orbital volüme augmentation was performed using the deep lateral wall through an upper eyelid crease incision. The only postoperative complaint was edema which was controlled by application of ice.

Keywords

Enophthalmos/surgery, eyelids/surgery, orbital fractures/surgery, prostheses and implants

References

• Goldberg RA, Saulny S, McCann JD, Yuen VH. Orbital volume augmentation for late enophthalmos using the deep lateral wall. Arch Facial Plast Surg 2003;5:256-8.
• Grant MP, Iliff NT, Manson PN. Strategies for the treat- ment of enophthalmos. Clin Plast Surg 1997;24:539-50.
• Jacono AA, Moskowitz B. Alloplastic implants for orbital wall reconstruction. Facial Plast Surg 2000;16:63-8.
• Karesh JW, Horswell BB. Correction of late enophthal- mos with polyethylene implant. J Craniomaxillofac Trauma 1996;2:18-23.
• Villarreal PM, Monje F, Morillo AJ, Junquera LM, Gonzalez C, Barbon JJ. Porous polyethylene implants in orbital floor reconstruction. Plast Reconstr Surg 2002;109:877-85.
• Celikoz B, Duman H, Selmanpakoglu N. Reconstruction of the orbital floor with lyophilized tensor fascia lata. J Oral Maxillofac Surg 1997;55:240-4.
• Morrison AD, Sanderson RC, Moos KF. The use of silastic as an orbital implant for reconstruction of orbital wall defects: review of 311 cases treated over 20 years. J Oral Maxillofac Surg 1995;53:412-7.
• Zide MF. Late posttraumatic enophthalmos corrected by dense hydroxylapatite blocks. J Oral Maxillofac Surg 1986;44:804-6.
• Iizuka T, Mikkonen P, Paukku P, Lindqvist C. Reconstruction of orbital floor with polydioxanone plate. Int J Oral Maxillofac Surg 1991;20:83-7.
• Hollier LH, Rogers N, Berzin E, Stal S. Resorbable mesh in the treatment of orbital floor fractures. J Craniofac Surg 2001;12:242-6.