Blow-out fracture in children

BARTOŇKOVÁ, Klára and Ivo ŠLAPÁK. Blow-out fracture in children. In 10 th International Otorhinolaryngology head and neck surgery congress. 2012.

Basic information

Original name

Blow-out fracture in children

Authors

BARTOŇKOVÁ, Klára and Ivo ŠLAPÁK

Edition

10 th International Otorhinolaryngology head and neck surgery congress, 2012

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Other information

Language

English

Type of outcome

Konferenční abstrakt

Field of Study

30200 3.2 Clinical medicine

Country of publisher

Czech Republic

Confidentiality degree

není předmětem státního či obchodního tajemství

Organization unit

Faculty of Medicine

Keywords in English

blow-out fracture; children; diplopia; transconjunctival aproach

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Abstract

V originále

In 1994 to 2009 were in Clinic of Children ENT, Faculty of medicine Masaryk University, Brno, hospitalized 25 patients with blow out fracture diagnosis, 19 was operated. Mean age of the patiens was 9,5 year, in the range of 5 to 18 years. The most frequent cause of injury was sport activity- 16 patients, child game- 3 patients, car accident-4 patients, dog bite 1, falling tree 1. 19 children had diplopia which occured at latest 3 days after injury, oedema and hematoma around orbita. All patients was investigated by CT or MR. CT scanes showed in 21 patients fracture of under orbita wall, 6 without herniation of the soft tissues to maxillar sinus and 4 patients had fracture of medial orbital wall. Fracture on the left side had 18 patients, on the right side 7 patients. Fracture on the under orbital wall was in 21 cases and 4 on the medial orbita wall. We operated 19 patients. Patiens -6, without diplopia, without herniation of the soft tissues to maxillar sinus, were treated conservatively. Reposition of the blow- out fracture was made by transconjunctival approach,on the upper side of orbital defect. After incision of conjunctiva, in under fornix, under orbital edge and then part of under orbital wall, was cleared. For releasing and elevating incarcerated orbital content, under wall was pressed down. In necessary cases,within the range of defect, was applicated Zenoderm or Goretx plate. Because of persisting diplopia revisional operation was necessary. The most advantageous aproach for reposition of hydraulic orbital fracture is transconjunctival approach, because of its good visual control, simplicity and also good cosmetical effect.