الفهرس | Only 14 pages are availabe for public view |
Abstract It was very important to clarify the following items in our review of literature; the anatomy of the orbit from its clinical aspect, differential diagnosis of the different orbital disorders especially from the ORL view, previous experiences of the endoscopic endonasal orbital decompression and its recorded complications and how to manage and finally the endoscopic endonasal orbital reconstruction and the summary of other approaches of orbital reconstruction and different methods of fracture bone support. In our study the aim of work was to clarify the role of endonasal endoscopic surgery in both orbital decompression and reconstruction of different causes and to evaluate the outcomes from this surgery. Our subjects were 54 patients divided into 5 groups; infection, inflammatory non infectious, neoplastic, congenital and traumatic groups according to the etiological causes. The main presentations in our patients were proptosis, vision impairment and limited ocular motility with diplopia. Our methods were pre and post operative history taking, radiological investigations include CT and MRI scan nose, paranasal sinuses, orbit and skull base, physical examinations include general, ophthalmic and ORL examination. Endoscopic endonasal surgery were done for all patient’s groups which aimed to orbital decompression in both intraconal and exrtaconal cases of orbital compression and the second aim was orbital reconstruction in traumatic group in both blowout fracture and trapdoor fracture. Summary and Conclusion ‐ 129 ‐ Results were calculated according to our study aimed to evaluate the outcomes of the endoscopic endonasal orbital decompression and orbital reconstruction. Our post operative outcomes were the proptosis reduction, vision improvement, ocular motility and diplopia. We founded a significant age and sex distribution among the studied groups with a mean age (29.6 years). The mean age was younger in congenital group (group 4) and the mean age was older in infection group (group 1). Our result showed a highly significant postoperative proptosis degree reduction in both infection and congenital groups and a significant postoperative proptosis reduction in the other groups. We founded that the mean of the postoperative proptosis reduction degree is highest in the infection group (4 mm) followed by the congenital group (3.8 mm). The most resolved sign in cases of orbital endoscopic decompression and reconstruction was the proptosis reduction degree followed by improved ocular motility then absence of dipolopia and finally improved vision. Operative or post operative complications which founded in our study were epistaxis in 2 patients, nasal adhesions in 3 patients, enophthalmos in 2 patients and diplopia in 9 patients which recorded as a complication not present preoperative or increased post operative. |