Preview

Russian journal of neurosurgery

Advanced search

Videoimage endoscopy in surgical treatment of patients with upper orbital roof fractures

https://doi.org/10.17650/1683-3295-2019-21-4-50-56

Abstract

The study objective is to assess the effectiveness and safety of videoimage endoscopy during minimally invasive surgery in fractures of the upper orbital roof.

Materials and methods. We examined and operated 9 patients (7 men and 2 women) aged 16 to 53 years (mean age 28.4 years) with fractures of the upper orbital roof with intraorbital (n = 7) and intracranial (n = 2) fragments displacement. Surgery was aimed at eliminating oculomotor disorders, preventing purulent-septic complications and restoring tightness of the intracranial space and orbital anatomy. All patients were operated using 4 mm rigid endoscopes with 0 and 30° viewing angles.

Results. All patients underwent fraction resection and intraorbital structures decompression. No case of intraoperative liquorrhea was registered. The surgery did not change visual acuity. Ocular motility disturbances were eliminated in all patients. Videoimage endoscopy made it possible to avoid wide craniotomy used to approach orbital roof and to shorten the rehabilitation period and hospitalization time. With intraorbital fragments displacement it allowed to reconstruct the orbit with minimal eyeball traction, while preserving important neurovascular bundles, as well as simultaneously revise dura mater and anterior cranial base in order to exclude intraoperative liquorrhea. No complications of surgical treatment were reported.

Conclusion. The results demonstrate the wide possibilities of endoscopy in cranioorbital lesions surgery.

Conflict of interest. The authors declare no conflict of interest.

Informed consent. All patients gave written informed consent to participate in the study

About the Authors

O. V. Levchenko
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
developing the research design, surgery treatment, article writing


A. A. Kalandari
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
surgery treatment, analysis of the obtained data, article writing


N. Yu. Kutrovskaya
A.I. Evdokimov Moscow State University of Medicine and Dentistry, Ministry of Health of Russia
Russian Federation
ophthalmological examination in pre- and postoperative periods


References

1. Husain M., Jha D., Vatsal D.K. et al. Neuroendoscopic transnasal repair of cerebrospinal fluid rhinorrhea. Skull Base 2003;13(2):73–8. DOI: 10.1055/s-2003-820561.

2. Rinna С., Rocchi G., Ventucci E. et al. Bilateral orbital roof fracture. J Craniofac Surg 2009;20(3):737–42. DOI: 10.1097/SCS.0b013e3181a2d9e4.

3. Strong E.B., Buchalter G.M., Moulthrop H.M. Endoscopic repair of isolated anterior table frontal sinus fractures. Arch Facial Plast Surg 2003;5(6):514–21. DOI: 10.1001/archfaci.5.6.514.

4. Gerbino R., Roccia F., Benech A., Caldarelli C. Аnalysis of 158 frontal sinus fractures: current surgical management and complications. J Craniomaxillofac Surg 2000;28(3):133–9. DOI: 10.1054/jcms.2000.0134.

5. Mueller R. Endoscopic treatment of facial fractures. Facial Plast Surg 2008;24(1): 78–91. DOI: 10.1055/s-2008-1037452.

6. Greenwald M.J., Boston D., Pensler J.M., Radkowski M.A. Orbital roof fractures in childhood. Ophthalmology 1989;96(4):491–6. DOI: 10.1016/s0161-6420(89)32868-5.

7. Facial plastic and reconstructive surgery. Ed. by I.D. Papel. Transl. from English. Moscow: Binom, 2007. 951 р. (In Russ.).

8. Eolchiian S.A., Potapov A.A., Serova N.K. et al. Reconstructive surgery of cranioorbital injuries. Zhurnal “Voprosy neirokhirurgii” im. N.N. Burdenko = N.N. Burdenko’s Journal of Neurosurgery 2011;75(2):25–40. (In Russ.).

9. Kalandari A.A., Levchenko O.V. The endoscopy method for reconstructive surgery of cranioorbital injuries. Part 1. Fractures of frontal sinus and orbital walls. Neyrokhirurgiya = Russian Journal of Neurosurgery 2013;(3):66–71. (In Russ.).

10. Levchenko O.V., Shalumov A.Z., Kutrovskaia N.Iu., Krylov V.V. Surgical treatment of cranioorbital injuries combined with brain trauma. Zhurnal “Voprosy neirokhirurgii” im. N.N. Burdenko = N.N. Burdenko’s Journal of Neurosurgery 2011;75(1):12–9. (In Russ.).

11. Lectures on traumatic brain injury. Ed. by V.V. Krylov. Moscow, 2010. 320 p. (In Russ.).

12. Graham H.D. 3rd, Spring P. Endoscopic repair of frontal sinus fracture: case report. J Craniomaxillofac Trauma 1996;2(4):52–5.

13. Fulcher T.P., Sullivan T.J. Orbital roof fractures: management of ophthalmic complications. Ophthalmic Plast Reconstr Surg 2003;19(5):359–63. DOI: 10.1097/01. IOP.0000083646.20672.6B.

14. Haug R.H., Nuveen E., Bredbenner T. An evaluation of the support provided by common internal orbital reconstruction materials. J Oral Maxillofac Surg 1999;57(5):564–70. DOI: 10.1016/s0278-2391(99)90076-9.

15. Dandy W. Pneumocephalus (intracranial pneumatocele or aerocele). Arch Surg 1926;12:949–82.

16. Grin A.A., Oshepkov S.K., Kaykov A.K., Aleynikova I.B. Videoendoscopic technique for treatment of spinal trauma and spinal diseases. Neyrokhirurgiya = Russian Journal of Neurosurgery 2013;(1):53–8. (In Russ.).

17. Krylov V.V., Dashyan V.G., Tkachev V.V. et al. The application of assisting endoscopy in the course of operations on cerebral vascular aneurysms. Neyrokhirurgiya = Russian Journal of Neurosurgery 2007;(3):18–25. (In Russ.).


Review

For citations:


Levchenko O.V., Kalandari A.A., Kutrovskaya N.Yu. Videoimage endoscopy in surgical treatment of patients with upper orbital roof fractures. Russian journal of neurosurgery. 2019;21(4):50-56. (In Russ.) https://doi.org/10.17650/1683-3295-2019-21-4-50-56

Views: 614


Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 License.


ISSN 1683-3295 (Print)
ISSN 2587-7569 (Online)
X