Repair of isolated “trap door” orbital floor fractures in children using auricular autocartilage
Author: Svitlana Tronina
Base Hospital / Institution: SI “The Filatov Institute of Eye Diseases and Tissue Therapy of AMSU”
ePoster presentation
Abstract ID: 25-323
Purpose
The common variant of orbital fractures in pediatric practice is “trap-door” floor damage, which reaches 25-70%. Various synthetic materials, as well as donor and autologous implants were proposed for restoration.
Methods
11 children aged 7-15 years (mean age 11,1 ± 2,4 years) were operated on for orbital floor fracture at the Pediatric Ophthalmopathology Department of the Filatov Institute. All children complained to diplopia. Clinically in all cases the enophthalmos in the range of 5-7 mm, limitation of upward eyeball mobility, decreased visual acuity of the eye on the side of fracture were determined. CT scans revealed the signs of fracture and orbital fat prolapse; іn 8 children, the inferior rectus muscle was clamped in the fracture zone.
Surgical treatment was performed in terms of 18-28 days after trauma, accordingly to the time of arrival at the institute. The restorative operation was performed by a transconjunctival approach using a fragment of the patient’s auricular cartilage, which was taken from the posterior surface of the auricle at the first stage of the operation. After the fracture zone revision and sparing reposition of the prolapsed soft tissues, the autocartilage plate was located under periosteum, overlapping the fracture zone.
Results
The operation and postoperative period proceeded without complications. After subsiding of postoperative edema and inflammation the normalization of the position and motility volume of the eyeball was marked. The diplopia gradually decreased until complete disappearance on the 6-25 days after the operation.
The control CT examination 3-6 months after the operation showed a stable position of the autocartilage plate implanted to the fracture zone, confirmed the absence of hernial protrusion of the orbital content.
Conclusion
The repair of “trap door” orbital floor fractures in children using autocartilage ensures effective consolidation of the fracture zone and has all the advantages of autoplastic interventions, including the absence of the rejection reaction, danger of implant dislocation and extrusion.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Nadiia | Bobrova | SI “The Filatov Institute of Eye Diseases and Tissue Therapy of AMSU” |
