_of enophthalmos and diplopia after 后眼球内陷和复视的持久性课件

Persistence of Enophthalmos and Diplopia After Transconjunctival vs. Endonasal Repair of Orbital Blowout Fractures Shivani Kamat, MD PI: Geeta Been, MD Background lOrbital blowout fractures are common injuries after facial trauma lMultiple surgical subspecialties can repair these with the use of various techniques nEndoscopic nasal repair nTransconjunctival repair Background lPre-operative diplopia and enophthalmos ( 2 mm) are common indications for repair Purpose lTo conduct a meta-analysis that compares the post-operative persistence of enophthalmos and diplopia between transconjunctival and endonasal repair of orbital blowout fractures Methods lReview of 13 retrospective studies describing post-operative diplopia and enophthalmos following endonasal and transconjunctival repair lStudies that combined various other approaches were excluded Methods lTotal of 408 repairs were evaluated n242 transconjunctival n166 endonasal lAnalysis nFishers exact test Results l242 patients with transconjunctival repair n34 (14%) with pre-operative enophthalmos n8 (3%) with post-operative enophthalmos l166 patients with endonasal repair n44 (27%) with pre-operative enophthalmos n9 (5%) with post-operative enophthalmos lOdds of persistent enophthalmos were 0.162 and 0.189 for TC and EN repairs lDifference between the two approaches was not statistically significant (p= 0.795) Results l242 patients with transconjunctival repair n103 (43%) with pre-operative diplopia n5 (2%) with post-operative diplopia l166 patients with endonasal repair n137 (83%) with pre-operative diplopia n25 (15%) with post-operative diplopia lOdds of persistent diplopia were 0.052 and 0.169 for TC and EN repairs lDifference between the two approaches was statistically significant (p= 0.005) Conclusions lTransconjunctival repair of OBF results in statistically significant reduced odds of persistent diplopia as compared to endonasal repair. lThere is no statistically significant difference in the persistence of enophthalmos between transconjunctival andendonasal repair of OBF. Conclusions lLimitations nAll variables unable to be standardized due to nature of meta-analyses nDifferent surgeons with different skill levels nVariability in implant product used during repair nDifferent inclusion criteria used in each individual study nDifferent thresholds for what constitutes enophthalmos and diplopia Conclusions lStrengths nGives preliminary insight into the differences in surgical outcomes between transconjunctival and endonasal approaches to o