[Clinical effect of orbit fracture reconstruction under nasal endoscope].

OBJECTIVE: To investigate the clinical effect of orbit blowout fracture reconstruction under nasal endoscope. METHODS: Forty-one cases of orbit fracture were reconstructed for lost or damaged orbit under nasal endoscope through maxillary sinus, ethmoidal sinus or the both. RESULTS: Among the 35 cases of orbit blowout fracture, enophthalmos in 33 cases were completely improved, 29 cases were symmetrical to normal eye after operation without diplopia except that 6 cases had slight enophthalmos accompanied with slight diplopia. Among these 6 cases, 4 cases returned to normal without diplopia 6 months after operation. In the 6 cases of orbit non-blowout fracture, 4 cases were symmetrical to normal eye after operation without enophthalmos, diplopia and facial malformation. One case had slight enophthalmos and diplopia, 1 case had slight enophthalmos with slight facial malformation. CONCLUSIONS: The surgery under nasal endoscope is safe and credible. The method can be easily mastered and its complication is less.

[Resection of tumors involving the cranio-naso-orbital area via fronto-orbito-ethmoidal approach].

OBJECTIVE: To introduce a better surgical approach for the resection of tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area. METHODS: A "T" form incision was made in the fronto-orbito-ethmoidal region and along the nasal pyramid down. Parts of ethmoid sinus, lamina papyracea, fronto-orbito bone and behind wall of frontal sinus were resected in order to expose the tumors in the anterior skull base and the fronto-orbito-ethmoidal region. Then, the tumor was resected partly under the operation microscope, protecting the neighbouring important structures, for instance: optic nerve, internal carotid artery, sella, meninx, etc. The nasal pyramid was repaired and fixed to the frontal bone with titanium board and titanium nail in order to resume the appearance of a good face. RESULTS: Thirteen patients received tumour resection through this approach. The patients were followed-up for 24 months, 11 patients showed no tumour recurrence, no severe complication, such as cerebrospinal rhinorrhea, meningoencephlocele, etc, in this series. The facial appearance was good. CONCLUSIONS: The approach via the fronto-orbito-ethmoidal region is a good surgical procedure to resect the tumors involving the anterior and middle skull base and the fronto-orbito-ethmoidal area.