gms | German Medical Science

The growth of technogenic and everyday traumas has been marked in the last years. Therefore, the problem of treatment of patients with the posttraumatic damages of the orbit is quite important.

Purpose of work: to study efficacy of reconstructive operations of the orbit in patients after a trauma.

The analysis of results was conducted in 69 patients aged from 8 to 79 (17 women and 52 men). The follow-up period was from 3 to 14 years. According to the data of the roentgenologic study all patients had damage of the orbit walls: lower, inner and outer - in 55 cases, and in 14 cases - damage of all orbit walls, cheek-bone, adjoining sinuses, floor of the anterior cranial fossa and basic bone. The operation consisted in implantation of the wedge-shaped homocartilage with the base to the top in the natural space between tissues surrounding the eyeball and lower orbit wall. Its subsequent transfer in the anterior-posterior direction resulted in displacement of the eyeball in the frontal and horizontal planes.

63 of 69 patients with enophthalmia from 3.0 to 6.0 mm had complete elimination of enophthalmia, and in 6 patients with initial enophthalmia from 6.0 mm and higher remaining enophthalmia was preserved within the limits of 3.0 – 4.0 mm. It is conditioned by multiple fractures in the orbit walls and adjoining nasal sinuses. 30 of 63 patients had restored mobility of the eyeball, and in other patients – it was partial. Diplopia was fully eliminated in 11 of 23 patients, and in 12 – it was retained only at the extreme eye abduction. Visual acuity increased from 0.5 to 1.0 in 12 of 29 patients. A postoperative period was uneventful.

The method of surgical treatment developed by us allowed to eliminate enophthalmia in 91.3% of cases, to restore mobility of the eyeball in 47.6% of cases and to improve visual acuity in 41.4% cases.