Abstract

VEGA LAGOS, O.A.; ABRIL RODRIGUEZ, J.E.; PENUELA BALAGUERA, L.F.  and  PARAMO JIMENEZ, V.G.. Tiered skull graft for the management of post-traumatic enophthalmos and dystopia. Rev Esp Cirug Oral y Maxilofac [online]. 2008, vol.30, n.6, pp.440-448. ISSN 2173-9161.

Almost 90%¹ of traumatic injuries to the craniofacial massif involve the eye sockets, and a large proportion of these injuries generate sequelae, such as post-traumatic enophthalmos and dystopia. The literature contains numerous references to surgical techniques for the correction of these sequelae and diverse materials for orbital reconstruction after trauma. However, few of them have been designed to restore the original anatomy of the orbital floor. For that reason, it is important to develop a simple and effective technique for correcting orbital damage. The present article describes the use of a new surgical technique for the management of the sequelae mentioned using a tiered skull graft on the floor of the orbit. It is an excellent option for graft placement because of its low resorption rate and minimal adverse reactions. Patients. Four patients (1 woman, 3 men), average age 23 years (range 17-27 years) and history of facial trauma with orbital involvement were treated between 2004 and 2007 at the Hospital Central de la Policía Nacional and Hospital El Tunal (Bogotá, Colombia). All of them authorized the procedure by signing an informed consent form. The tiered graft technique was used for the post-traumatic correction of enophthalmos and dystopia. Results with a follow-up time of 11 to 42 weeks are reported. Results. All the patients exhibited a reduction in the eye socket and symmetrical projection of the eyeball in anteroposterior and vertical direction, as well as complete improvement of the diplopia after the tiered skull graft was used to repair the orbital floor. Conclusion. The technique is simple and inexpensive, with minimal morbidity and predictable and satisfactory results in the short and intermediate term.

Keywords : Blow out; Enophthalmos; Diplopia; Dystopia; Cranium.

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