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Rivista Italiana di Chirurgia Maxillo-Facciale 2002 April;13(1):15-9

Copyright © 2003 EDIZIONI MINERVA MEDICA

language: English

Retrocaruncular incision for access to the medial wall of the orbit

Raffaini M., Ghilardi R., Spinelli G., Giannini D.

Department of Maxillo-Facial Surgery, CTO Careggi, University of the Study, Florence


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Background. There ­are ­many lim­its ­and com­pli­ca­tions, chief­ly of an aes­thet­ic ­nature, of ­the sur­gi­cal ­access tech­niques tra­di­tion­al­ly ­used to ­reach ­the medi­al ­wall of ­the ­orbit. This ­report ­describes ­the ret­ro-carun­cu­lar con­junc­ti­val sur­gi­cal ­access tech­nique to ­explore ­and ­reduce frac­tures of ­the medi­al orbi­tal ­wall.
Methods. We ­applied ­this sur­gi­cal tech­nique to ­five cas­es of frac­ture of ­the medi­al ­wall, recon­struct­ed ­with ­bone ­graft ­from ­the ­iliac ­crest in ­two cas­es, ­with sep­tal car­til­age in ­two cas­es, ­and ­with allo­plas­tic mate­ri­al in ­the ­fifth ­case (Medpor).
Results. In ­all ­five cas­es treat­ed, ­access ­was ­found to be ­quick ­and rel­a­tive­ly ­easy, ­and to pro­vide ade­quate expo­sure of ­the frac­ture ­and suf­fi­cient free­dom of sur­gi­cal move­ment. All ­patients, at ­one ­year fol­low-up, pre­sent­ed stabil­ity of ­the recon­struct­ed ­wall without enophtalmos or diplopia; clin­i­cal ocu­lar com­pli­ca­tions, in par­tic­u­lar to ­the lac­ri­mal struc­tures ­and con­junc­ti­val tis­sues, ­were ­not ­present in ­any of ­the cas­es.
Conclusions. We ­may con­clude ­that ­this ­access ­route is effi­ca­cious to ­explore ­and ­reduce frac­tures of ­the medi­al ­wall of ­the ­orbit.

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