상악동 전벽 이식술을 이용한 안와의 True Blow-out Fracture 처치

Management of true blow-out fractures of the orbital floor by transplant of anterior wall of the maxillary sinus

Bony anatomy of the orbit is composed of frontal bone, maxilla, zygomatic bone, sphenoid, ethmoid, lacrimal bone, and palatine bone. Frontal bone, maxilla, and zygomatic bone are particularly strong, but the walls of funnel-shaped orbit consist in part of very thin bony lamellae, with only little resistance to trauma. These anatomic factors explain the very special fracture mechanisms that prevail in the orbital region, especially true blow-out fracture of the orbital floor. In 1957, Smith and Regan originated the term blow-out fracture to describe a specific type of fracture of the orbital floor without fracture of the orbital rim and with entrapment of one or more orbital soft tissue structures, thus limiting vertical ocular mobility and causing diplopia and enophthalmos. At least four methods of rebuilding the orbital floor are commonly employed. These include repositioning of the displaced bones ; use of alloplastic graft material such as Marlex mesh, Silastic, and Teflon ; autogenous bone grafts ; homografts such as lyophilized dura. This report presents 3 cases of true blow-out fracture of the orbital floor that was treated by autogenous bone graft, especially thin transplants from anterior wall of the maxillary sinus.