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Assessment of Endoscopic Role in Management of Facial Fractures

Received: 7 November 2014     Accepted: 16 November 2014     Published: 17 December 2014
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Abstract

This study evaluates the usefulness of endoscopic repair in certain types of facial fractures (orbital floor, isolated zygomatic arch and isolated anterior table frontal sinus fractures).Endoscopic application in otorhinolaryngology has expanded into many areas including facial plastic surgery and facial trauma (orbital blow-out, frontal sinus, zygomatic arch, and subcondylar fractures), therefore limiting the use of incisions for exposure. Endoscopically assisted facial bone surgery can be performed with many advantages, including: magnified direct visualization, decreased scarring, avoidance of numbness beyond the incision line, greater acceptability to the patient, decreased complication rate and short hospitalization. For assessment of the value of endoscopy in repair of certain facial fractures, we selected 12 consented patients with either orbital floor fracture, isolated zygomatic arch fracture or isolated anterior table frontal sinus fracture to be involved in our study after stabilizing the general condition. The patients were evaluated preoperatively by an ophthalmologist and all had complete CT study including coronal, axial (both bony and soft-tissue windows), sagital and 3D images. The patients were analyzed for sex, age, time of surgery, pre/postoperative symptoms; including ophthalmic symptoms, facial paraesthesia and aesthetic problems. The results of our endoscopic approach were evaluated esthetically and functionally to be classified into good, fair and poor results. We also classified the level of the surgery according to its difficulty into difficult, average and easy surgical performance.Good results were achieved in 8fractures (42%); fair in 8fractures (42%) and finally 3fractures (16%) with poor endoscopic result. The performed surgery considered easy in 9 (41%) patients, average in 6 (31%) patients and difficult in 4 (21%) patients. All patients had no significant complications. Conclusion: Endoscopic repair appears to be a safe and effective technique for repairing certain types of facial fracture.

Published in American Journal of Health Research (Volume 2, Issue 6)
DOI 10.11648/j.ajhr.20140206.22
Page(s) 392-396
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2014. Published by Science Publishing Group

Keywords

Endoscopic Repair, Orbital Floor Fracture, Zygomatic Arch Fracture, Frontal Sinus Fracture

References
[1] Pham AM and Strong EB. Endoscopic management of facial fractures. Current Opinion in Otolaryngology & Head and Neck Surgery 2006; 14:234-241.
[2] Chen CT, Lai JP, Chen YR, et al. Application of endoscope in zygomatic fracture repair. Br J PlastSurg2000; 53:100–105.
[3] Perry M. Maxillofacial trauma—Developments, innovations and controversies. Injury 2009; 40:1252–1259.
[4] Katz RL, McCain JP, Mogollon E, Kaltman SI. Endoscopically-assisted oral and maxillofacial surgery: Experiences and observations. Oral Surgery, Oral Medicine, Oral Pathology, Oral Radiology, and Endodontology2006; 101:43.
[5] Filiaci F, Riccardi E, Ungari C, Rinna C, Quarato D. Endoscopic approach to maxillo-facial trauma. AnnaliItaliani Di Chirurgia2013; 84:371-376.
[6] Kang SH, Choi EJ, Kim HW, Kim HJ, Cha IH, Woong N. Complications in endoscopic-assisted open reduction and internal fixation of mandibular condyle fractures. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology 2012; 113:201-206.
[7] Park DH, Lee JW, Song CH, Han DGil, Ahn KY. Endoscopic Application in Aesthetic and Reconstructive Facial Bone Surgery Plastic & Reconstructive Surgery 1998; 102:1199-1209.
[8] Kelley P, Hopper R, Gruss J. Evaluation and treatment of zygomatic fractures. PlastReconstr Surg. 2007; 120(suppl 2).
[9] Jin HR, Yeon JY, Shin SO, Choi YS, Lee DW. Endoscopic versus external repair of orbital blowout fractures. Otolaryngol Head Neck Surg2007; 136:38-44.
[10] Lee T, Ratzker P, Galarza M, Villanueva P. Early Combined Management of Frontal Sinus and Orbital and Facial Fractures. The Journal of Trauma: Injury, Infection, and Critical Care 1998; 44: 665-669.
[11] Ducic Y, Verret D. Endoscopic transantral repair of orbital floor fractures. Otolaryngol Head Neck Surg 2009; 140:849–854.
[12] Mensink G, Zweers A, van Merkesteyn J. Endoscopically assisted reduction of anterior table frontal sinus fractures. Int. J. Oral Maxillofac. Surg 2009; 37:225-228.
[13] Hundepool C, Willemsen M, Koudstaal M, van der Wal K. Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis. Int. J. Oral Maxillofac. Surg. 2012; 41: 489–493.
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    Mohammad Noaman Mohammad Ali, Abdel-Hay Rashad El-Assy MD, El-Hussainy El-Hussainy Shreef MD, Yasser Abd El-wahab Khalil MD, Yasser Mohmmed Al-Sheikh MD. (2014). Assessment of Endoscopic Role in Management of Facial Fractures. American Journal of Health Research, 2(6), 392-396. https://doi.org/10.11648/j.ajhr.20140206.22

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    ACS Style

    Mohammad Noaman Mohammad Ali; Abdel-Hay Rashad El-Assy MD; El-Hussainy El-Hussainy Shreef MD; Yasser Abd El-wahab Khalil MD; Yasser Mohmmed Al-Sheikh MD. Assessment of Endoscopic Role in Management of Facial Fractures. Am. J. Health Res. 2014, 2(6), 392-396. doi: 10.11648/j.ajhr.20140206.22

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    AMA Style

    Mohammad Noaman Mohammad Ali, Abdel-Hay Rashad El-Assy MD, El-Hussainy El-Hussainy Shreef MD, Yasser Abd El-wahab Khalil MD, Yasser Mohmmed Al-Sheikh MD. Assessment of Endoscopic Role in Management of Facial Fractures. Am J Health Res. 2014;2(6):392-396. doi: 10.11648/j.ajhr.20140206.22

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  • @article{10.11648/j.ajhr.20140206.22,
      author = {Mohammad Noaman Mohammad Ali and Abdel-Hay Rashad El-Assy MD and El-Hussainy El-Hussainy Shreef MD and Yasser Abd El-wahab Khalil MD and Yasser Mohmmed Al-Sheikh MD},
      title = {Assessment of Endoscopic Role in Management of Facial Fractures},
      journal = {American Journal of Health Research},
      volume = {2},
      number = {6},
      pages = {392-396},
      doi = {10.11648/j.ajhr.20140206.22},
      url = {https://doi.org/10.11648/j.ajhr.20140206.22},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20140206.22},
      abstract = {This study evaluates the usefulness of endoscopic repair in certain types of facial fractures (orbital floor, isolated zygomatic arch and isolated anterior table frontal sinus fractures).Endoscopic application in otorhinolaryngology has expanded into many areas including facial plastic surgery and facial trauma (orbital blow-out, frontal sinus, zygomatic arch, and subcondylar fractures), therefore limiting the use of incisions for exposure. Endoscopically assisted facial bone surgery can be performed with many advantages, including: magnified direct visualization, decreased scarring, avoidance of numbness beyond the incision line, greater acceptability to the patient, decreased complication rate and short hospitalization. For assessment of the value of endoscopy in repair of certain facial fractures, we selected 12 consented patients with either orbital floor fracture, isolated zygomatic arch fracture or  isolated anterior table frontal sinus fracture to be involved in our study after stabilizing the general condition. The patients were evaluated preoperatively by an ophthalmologist and all had complete CT study including coronal, axial (both bony and soft-tissue windows), sagital and 3D images. The patients were analyzed for sex, age, time of surgery, pre/postoperative symptoms; including ophthalmic symptoms, facial paraesthesia and aesthetic problems.  The results of our endoscopic approach were evaluated esthetically and functionally to be classified into good, fair and poor results. We also classified the level of the surgery according to its difficulty into difficult, average and easy surgical performance.Good results were achieved in 8fractures (42%); fair in 8fractures (42%) and finally 3fractures (16%) with poor endoscopic result. The performed surgery considered easy in 9 (41%) patients, average in 6 (31%) patients and difficult in 4 (21%) patients. All patients had no significant complications. Conclusion: Endoscopic repair appears to be a safe and effective technique for repairing certain types of facial fracture.},
     year = {2014}
    }
    

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    AU  - Mohammad Noaman Mohammad Ali
    AU  - Abdel-Hay Rashad El-Assy MD
    AU  - El-Hussainy El-Hussainy Shreef MD
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    AU  - Yasser Mohmmed Al-Sheikh MD
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    DO  - 10.11648/j.ajhr.20140206.22
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    JF  - American Journal of Health Research
    JO  - American Journal of Health Research
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    PB  - Science Publishing Group
    SN  - 2330-8796
    UR  - https://doi.org/10.11648/j.ajhr.20140206.22
    AB  - This study evaluates the usefulness of endoscopic repair in certain types of facial fractures (orbital floor, isolated zygomatic arch and isolated anterior table frontal sinus fractures).Endoscopic application in otorhinolaryngology has expanded into many areas including facial plastic surgery and facial trauma (orbital blow-out, frontal sinus, zygomatic arch, and subcondylar fractures), therefore limiting the use of incisions for exposure. Endoscopically assisted facial bone surgery can be performed with many advantages, including: magnified direct visualization, decreased scarring, avoidance of numbness beyond the incision line, greater acceptability to the patient, decreased complication rate and short hospitalization. For assessment of the value of endoscopy in repair of certain facial fractures, we selected 12 consented patients with either orbital floor fracture, isolated zygomatic arch fracture or  isolated anterior table frontal sinus fracture to be involved in our study after stabilizing the general condition. The patients were evaluated preoperatively by an ophthalmologist and all had complete CT study including coronal, axial (both bony and soft-tissue windows), sagital and 3D images. The patients were analyzed for sex, age, time of surgery, pre/postoperative symptoms; including ophthalmic symptoms, facial paraesthesia and aesthetic problems.  The results of our endoscopic approach were evaluated esthetically and functionally to be classified into good, fair and poor results. We also classified the level of the surgery according to its difficulty into difficult, average and easy surgical performance.Good results were achieved in 8fractures (42%); fair in 8fractures (42%) and finally 3fractures (16%) with poor endoscopic result. The performed surgery considered easy in 9 (41%) patients, average in 6 (31%) patients and difficult in 4 (21%) patients. All patients had no significant complications. Conclusion: Endoscopic repair appears to be a safe and effective technique for repairing certain types of facial fracture.
    VL  - 2
    IS  - 6
    ER  - 

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Author Information
  • Otorhinolaryngology- Faculty of Medicine-Menoufia University- Shebin El-Kom- Egypt

  • Otorhinolaryngology- Faculty of Medicine-Menoufia University- Shebin El-Kom- Egypt

  • Otorhinolaryngology- Faculty of Medicine-Menoufia University- Shebin El-Kom- Egypt

  • Otorhinolaryngology- Faculty of Medicine-Menoufia University- Shebin El-Kom- Egypt

  • Plastic surgery- Faculty of Medicine- Menoufia University- Shebin El-Kom- Egypt

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