Antibiotic Prophylaxis' Effect on Enophthalmos in Orbital Floor Fracture with Chronic Maxillary Sinusitis

ABSTRACT

PURPOSE: Orbital floor fracture has open wound to maxillary sinus and if the patient has chronic maxillary sinusitis, it may be have more risk of infection, complications. The purpose of this comparative study is to be the effectiveness of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis. METHODS: We studied 20 patients who diagnosed as orbital floor fracture with chronic maxillary sinusitis from march, 2005 to may, 2006. Among them 16 were male, 4 were female and age was ranged from 15 to 68, average was 42. A day before operation, Prophylactic antibiotics were used to 10 patients. Prophylactic antibiotics were not used to 10 patients. We defined control group as prophylactic antibiotics injection group a day before operation. After surgery, we confined use of same antibiotic for 7 days in both group. After 6 month from surgery, we compare the degree of enophthalmos from healthy side to legion side with hertel exopthalmometry(Inami, Japan) in control group and non-prophylactic antibiotics injection group. RESULTS: In control group, comparison of discrepancy between enophthalmic eyeball and normal eyeball with Hertel exophthalmometer was 1.1mm and non-prophylactic antibiotics injection group was 2.1mm. In independent sample t-test, control group was showed statistically significant difference with non-prophylactic antibiotics injection group(p=0.007). CONCLUSIONS: In orbital floor fracture with chronic maxillary sinusitis, bacteria in maxillary sinus can increase post-operative complication by infecting infraorbital soft tissue, and it is thought to be antibiotic prophylaxis is play a role in decrease in degree of enophthalmos. We feel the need to further study of prophylactic antibiotics in orbital floor fracture with chronic maxillary sinusitis.