Clinical characteristics and treatment of blow-out fracture accompanied by canalicular laceration

Hwa Lee, Jaemoon Ahn, Tae Eun Lee, Jong Mi Lee, Hyungho Shin, Mijung Chi, Minsoo Park, Se Hyun Baek

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Backgrounds: Blow-out fracture and canalicular laceration can occur simultaneously as a result of the same trauma. Despite its importance, little research has been conducted to identify clinical characteristics or surgical techniques for repair of a blow-out fracture accompanied by canalicular laceration. The aim of this study was to evaluate the clinical characteristics, the surgical approach, and the outcomes. Methods: Thirty-four eyes of 34 patients who underwent simultaneous repair of canalicular laceration using silicone tube intubation and reconstruction of blow-out fracture were included. Medical records were retrospectively reviewed for patient demographics, nature of injury, affected canaliculus, location, and severity of blowout fracture, associated facial bone fracture, ophthalmic diagnosis, length of follow-up period, and surgical outcome. Results: Mean patient age was 40.0 years (range, 17-71 y). The mean follow-up was 7.3 months. Fist to the orbital area (10 patients, 29.4%) was the most common cause. There were 24 lower canalicular lacerations (70.6%), 6 upper canalicular lacerations (17.6%), and 4 upper and lower canalicular lacerations (11.8%). Isolated medial wall fractures were most common (area A4: 20/34, 58.8%). Fractures involving both the floor and medial wall and maxilloethmoidal strut (areas A1, A2, A3, and A4) were the second most common (6/34, 17.6%), and floor and medial wall with intact strut (areas A1, A2, and A4) were injured in 6 patients (17.6%). Pure inferior wall fractures were least frequent (areas A1 and A2: 2/34, 5.9%). The severity of the fracture was severe in most patients except for 1 linear fracture with tissue entrapment and 1 moderate medialwall fracture (32/34, 94.1%). There was lid laceration in 20 patients (58.8%). Nasal bone fracture (5/34, 14.7%) was the most common facial bone fracture. Tubes were removed at a mean of 3.3 months (range, 3-4 mo). In total, 31 patients (91.2%) achieved complete success in canalicular laceration and blow-out fracture repair. No significant complications were encountered. Conclusion: Fractures involving the medial wall with a lower canalicular laceration were the most common among concomitant blow-out fractures and canalicular lacerations. The severity of the fracturewas most often classified as severe. Computed tomographic scan of the orbit and facial bones for identification of any additional injuries such as orbital wall and facial bone fractures should be performed in patients with canalicular laceration. To avoid disruption of the medial canthal area, repair of the canalicular laceration with silicone tube intubation was performed before reconstruction of the blow-out fracture through transconjunctival and transcaruncular approaches. Finally, the tube was fixed after blow-out fracture surgery, and these surgical orders yielded good surgical outcomes without complications.

Original languageEnglish
Pages (from-to)1399-1403
Number of pages5
JournalJournal of Craniofacial Surgery
Volume23
Issue number5
DOIs
Publication statusPublished - 2012 Sep 1

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Orbital Fractures
Lacerations
Facial Bones
Bone Fractures
Therapeutics
varespladib methyl
Silicones
Intubation
Wounds and Injuries
Nasal Bone
Orbit
Prefrontal Cortex
Medical Records

Keywords

  • Blow-out fracture
  • Canalicular laceration
  • Transconjunctival and transcaruncular approaches

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology

Cite this

Clinical characteristics and treatment of blow-out fracture accompanied by canalicular laceration. / Lee, Hwa; Ahn, Jaemoon; Lee, Tae Eun; Lee, Jong Mi; Shin, Hyungho; Chi, Mijung; Park, Minsoo; Baek, Se Hyun.

In: Journal of Craniofacial Surgery, Vol. 23, No. 5, 01.09.2012, p. 1399-1403.

Research output: Contribution to journalArticle

Lee, Hwa ; Ahn, Jaemoon ; Lee, Tae Eun ; Lee, Jong Mi ; Shin, Hyungho ; Chi, Mijung ; Park, Minsoo ; Baek, Se Hyun. / Clinical characteristics and treatment of blow-out fracture accompanied by canalicular laceration. In: Journal of Craniofacial Surgery. 2012 ; Vol. 23, No. 5. pp. 1399-1403.
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abstract = "Backgrounds: Blow-out fracture and canalicular laceration can occur simultaneously as a result of the same trauma. Despite its importance, little research has been conducted to identify clinical characteristics or surgical techniques for repair of a blow-out fracture accompanied by canalicular laceration. The aim of this study was to evaluate the clinical characteristics, the surgical approach, and the outcomes. Methods: Thirty-four eyes of 34 patients who underwent simultaneous repair of canalicular laceration using silicone tube intubation and reconstruction of blow-out fracture were included. Medical records were retrospectively reviewed for patient demographics, nature of injury, affected canaliculus, location, and severity of blowout fracture, associated facial bone fracture, ophthalmic diagnosis, length of follow-up period, and surgical outcome. Results: Mean patient age was 40.0 years (range, 17-71 y). The mean follow-up was 7.3 months. Fist to the orbital area (10 patients, 29.4{\%}) was the most common cause. There were 24 lower canalicular lacerations (70.6{\%}), 6 upper canalicular lacerations (17.6{\%}), and 4 upper and lower canalicular lacerations (11.8{\%}). Isolated medial wall fractures were most common (area A4: 20/34, 58.8{\%}). Fractures involving both the floor and medial wall and maxilloethmoidal strut (areas A1, A2, A3, and A4) were the second most common (6/34, 17.6{\%}), and floor and medial wall with intact strut (areas A1, A2, and A4) were injured in 6 patients (17.6{\%}). Pure inferior wall fractures were least frequent (areas A1 and A2: 2/34, 5.9{\%}). The severity of the fracture was severe in most patients except for 1 linear fracture with tissue entrapment and 1 moderate medialwall fracture (32/34, 94.1{\%}). There was lid laceration in 20 patients (58.8{\%}). Nasal bone fracture (5/34, 14.7{\%}) was the most common facial bone fracture. Tubes were removed at a mean of 3.3 months (range, 3-4 mo). In total, 31 patients (91.2{\%}) achieved complete success in canalicular laceration and blow-out fracture repair. No significant complications were encountered. Conclusion: Fractures involving the medial wall with a lower canalicular laceration were the most common among concomitant blow-out fractures and canalicular lacerations. The severity of the fracturewas most often classified as severe. Computed tomographic scan of the orbit and facial bones for identification of any additional injuries such as orbital wall and facial bone fractures should be performed in patients with canalicular laceration. To avoid disruption of the medial canthal area, repair of the canalicular laceration with silicone tube intubation was performed before reconstruction of the blow-out fracture through transconjunctival and transcaruncular approaches. Finally, the tube was fixed after blow-out fracture surgery, and these surgical orders yielded good surgical outcomes without complications.",
keywords = "Blow-out fracture, Canalicular laceration, Transconjunctival and transcaruncular approaches",
author = "Hwa Lee and Jaemoon Ahn and Lee, {Tae Eun} and Lee, {Jong Mi} and Hyungho Shin and Mijung Chi and Minsoo Park and Baek, {Se Hyun}",
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T1 - Clinical characteristics and treatment of blow-out fracture accompanied by canalicular laceration

AU - Lee, Hwa

AU - Ahn, Jaemoon

AU - Lee, Tae Eun

AU - Lee, Jong Mi

AU - Shin, Hyungho

AU - Chi, Mijung

AU - Park, Minsoo

AU - Baek, Se Hyun

PY - 2012/9/1

Y1 - 2012/9/1

N2 - Backgrounds: Blow-out fracture and canalicular laceration can occur simultaneously as a result of the same trauma. Despite its importance, little research has been conducted to identify clinical characteristics or surgical techniques for repair of a blow-out fracture accompanied by canalicular laceration. The aim of this study was to evaluate the clinical characteristics, the surgical approach, and the outcomes. Methods: Thirty-four eyes of 34 patients who underwent simultaneous repair of canalicular laceration using silicone tube intubation and reconstruction of blow-out fracture were included. Medical records were retrospectively reviewed for patient demographics, nature of injury, affected canaliculus, location, and severity of blowout fracture, associated facial bone fracture, ophthalmic diagnosis, length of follow-up period, and surgical outcome. Results: Mean patient age was 40.0 years (range, 17-71 y). The mean follow-up was 7.3 months. Fist to the orbital area (10 patients, 29.4%) was the most common cause. There were 24 lower canalicular lacerations (70.6%), 6 upper canalicular lacerations (17.6%), and 4 upper and lower canalicular lacerations (11.8%). Isolated medial wall fractures were most common (area A4: 20/34, 58.8%). Fractures involving both the floor and medial wall and maxilloethmoidal strut (areas A1, A2, A3, and A4) were the second most common (6/34, 17.6%), and floor and medial wall with intact strut (areas A1, A2, and A4) were injured in 6 patients (17.6%). Pure inferior wall fractures were least frequent (areas A1 and A2: 2/34, 5.9%). The severity of the fracture was severe in most patients except for 1 linear fracture with tissue entrapment and 1 moderate medialwall fracture (32/34, 94.1%). There was lid laceration in 20 patients (58.8%). Nasal bone fracture (5/34, 14.7%) was the most common facial bone fracture. Tubes were removed at a mean of 3.3 months (range, 3-4 mo). In total, 31 patients (91.2%) achieved complete success in canalicular laceration and blow-out fracture repair. No significant complications were encountered. Conclusion: Fractures involving the medial wall with a lower canalicular laceration were the most common among concomitant blow-out fractures and canalicular lacerations. The severity of the fracturewas most often classified as severe. Computed tomographic scan of the orbit and facial bones for identification of any additional injuries such as orbital wall and facial bone fractures should be performed in patients with canalicular laceration. To avoid disruption of the medial canthal area, repair of the canalicular laceration with silicone tube intubation was performed before reconstruction of the blow-out fracture through transconjunctival and transcaruncular approaches. Finally, the tube was fixed after blow-out fracture surgery, and these surgical orders yielded good surgical outcomes without complications.

AB - Backgrounds: Blow-out fracture and canalicular laceration can occur simultaneously as a result of the same trauma. Despite its importance, little research has been conducted to identify clinical characteristics or surgical techniques for repair of a blow-out fracture accompanied by canalicular laceration. The aim of this study was to evaluate the clinical characteristics, the surgical approach, and the outcomes. Methods: Thirty-four eyes of 34 patients who underwent simultaneous repair of canalicular laceration using silicone tube intubation and reconstruction of blow-out fracture were included. Medical records were retrospectively reviewed for patient demographics, nature of injury, affected canaliculus, location, and severity of blowout fracture, associated facial bone fracture, ophthalmic diagnosis, length of follow-up period, and surgical outcome. Results: Mean patient age was 40.0 years (range, 17-71 y). The mean follow-up was 7.3 months. Fist to the orbital area (10 patients, 29.4%) was the most common cause. There were 24 lower canalicular lacerations (70.6%), 6 upper canalicular lacerations (17.6%), and 4 upper and lower canalicular lacerations (11.8%). Isolated medial wall fractures were most common (area A4: 20/34, 58.8%). Fractures involving both the floor and medial wall and maxilloethmoidal strut (areas A1, A2, A3, and A4) were the second most common (6/34, 17.6%), and floor and medial wall with intact strut (areas A1, A2, and A4) were injured in 6 patients (17.6%). Pure inferior wall fractures were least frequent (areas A1 and A2: 2/34, 5.9%). The severity of the fracture was severe in most patients except for 1 linear fracture with tissue entrapment and 1 moderate medialwall fracture (32/34, 94.1%). There was lid laceration in 20 patients (58.8%). Nasal bone fracture (5/34, 14.7%) was the most common facial bone fracture. Tubes were removed at a mean of 3.3 months (range, 3-4 mo). In total, 31 patients (91.2%) achieved complete success in canalicular laceration and blow-out fracture repair. No significant complications were encountered. Conclusion: Fractures involving the medial wall with a lower canalicular laceration were the most common among concomitant blow-out fractures and canalicular lacerations. The severity of the fracturewas most often classified as severe. Computed tomographic scan of the orbit and facial bones for identification of any additional injuries such as orbital wall and facial bone fractures should be performed in patients with canalicular laceration. To avoid disruption of the medial canthal area, repair of the canalicular laceration with silicone tube intubation was performed before reconstruction of the blow-out fracture through transconjunctival and transcaruncular approaches. Finally, the tube was fixed after blow-out fracture surgery, and these surgical orders yielded good surgical outcomes without complications.

KW - Blow-out fracture

KW - Canalicular laceration

KW - Transconjunctival and transcaruncular approaches

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