Application of endoscope and conventional techniques in management of Orbital Floor and Infra-orbital Rim Fracture Reduction

2016 
Introduction: Fractures of the orbital floor, which are caused by various mechanisms, result in the herniation of periorbital tissue into the paranasal sinuses and its subsequent complications. Early diagnosis using various techniques and reduction of fractures are necessary to preserve ocular function and esthetic. Use of an endoscope has been associated with some advantages, including a decrease in the number of external incisions and soft tissue manipulations. The aim of the present study was to evaluate complications of reducing fractures of the orbital floor and the infra-orbital rim with the use of an endoscope and conventional techniques. Materials and Methods: A total of 40 patients with fractures of the orbital floor were included in this clinical trial. The subjects were equally divided into two groups (n = 20). In Group 1, the complications of treatment with an endoscopic view were evaluated in addition to comparison of the sensitivity of endoscope and 3-mm computed tomography (CT) slices with the gold standard. In Group 2, complications of treatment with the conventional technique were compared with those in Group 1. T-test, chi-squared and Fisher’s exact tests, ANOVA and Tukey test for multiple comparisons were used for statistical analyses with SPSS statistical software. Result: There were no statistically significant differences between the two groups regarding age and gender. The sensitivity of the endoscope-assisted surgery in comparison to the gold standard was estimated to be 70% with a sensitivity of 85% in comparison to 3-mm CT scan slices. There was a significant difference between the two groups regarding complications, including edema, lower eyelid scars (P = 0.024), indicating superiority of the endoscope-assisted technique. Conclusion: The present study showed the importance of the CT scan as a diagnostic technique. In addition, the efficacy of the endoscopic technique in decreasing complications and improving the quality of orbital floor fracture treatment outcomes was confirmed.
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