Patient with naso-ethmoid orbital fracture and inferior orbital wall fracture came to the emergency unit of zagazig university hospital in egypt after motor car accident.
Patient at the time of examination showed edema and bruises in his left eye and nasal bridge. There was a step in the inferior orbital wall on the left side and irregularity of the inferior orbital margin.
CT computed tomography scan of the facial bone ( axial , coronal, and 3D ) showed naso-orbital ethmoidal fracture in place type 1, Fracture of the inferior orbital wall on left side with displacement.
Orbital content was normal with good visual acuity and normal extra-ocular movement. There was no entrapement of the inferior rectus muscle or the inferior oblique muscle. No ectopia or enophthalmous were present.
Patient was prepared for maxillo-facial surgery. Under general anesthesia, local anesthetic was infiltrated and subciliary approach was performed to reach the inferior orbital wall fracture. Fractured segment was reduced and fixation done by micro-titanium plates and screws a long the inferior orbital margin with C shaped plate. The naso-ethmoidal fractured was approached by lynch incision a long the nasal process of maxilla. Naso-ethmoidal bone was reduced and fixated by micro-titanium plate and screws.
The wound closed by absorbable vicryl 6/0 suture and patient observed for the night and discharged from the hospital in the next day.
It is preferable to use micro-plates and screws in the upper face area to avoid being palpable and to avoid excessive heating when patient face exposed to the sun.
At the end of the operation the patient was tested for forced induction test of ocular movement.
To avoid ectropion, the surgeon should be expirenced with the subciliary approach and elevation of the skin muscle ( orbicularis oculi ) flap.
Facial suspension was done to avoid cheek dropping and asymmetry post- operartive.
مركز الدكتور / محمد ربيع خيري
إستشاري الأنف والأذن والحنجرة و جراحات تجميل الأنف ومناظير الجيوب الانفية بالزقازيق.
*العنوان: الزقازيق - ميدان الصاغة - برج الصاغة - أول الكوبري أعلى صيدلية العوضي
*مواعيد الكشف بالمركز: من السبت إلى الخميس
من ٥ الى ٨ مساءا
* تليفون الحجز ٠١٠٦٦٢١٤٤٩٦
*سعر الكشف ١٠٠ جنيه و الكشف بالمناظير
دكتور محمد ربيع خيري انف واذن
ميدان الصاغة, Kafr Al Hosr, Zakazik First, Ash Sharqia Governorate 44511
0106 621 4496
https://maps.app.goo.gl/WnDRqtftFTN4We1R7
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