Objective To explore the perioperative comprehensive nursing of porous high-density polyethylene（Medpor） implant through endoscopic transcaruncular approach in the treatment of medial orbital fracture. Methods A total of 17 patients with medial orbital fracture accompanied by enophthalmos and diplopia admitted from January 2021 to January 2024 were selected. After determining the fracture scope and soft tissue injury degree by imaging, an endoscopic transcaruncular approach was used under general anesthesia to restore depressed orbital contents into the orbit and reconstruct the fracture site by Medpor implant. The postoperative outcomes were evaluated. In the perioperative period, after comprehensive nursing intervention was implemented, patients' anxiety, depression, and life quality scores were compared before and after nursing, and patients' satisfaction with nursing was recorded. Results After operation, diplopia, binocular prominence difference, eye movement grade, and best corrected visual acuity were all significantly improved than those before （P<0.05）, and the treatment effective rate was 94.12%. All patients successfully completed the operation, and no complications such as infection, displacement of implant, or rejection occurred during the follow-up period. The proportions of patients with conjunctival tissue edema and eyelid edema at 3 months after operation were significantly lower than those at 1 week after operation （P<0.05）. After comprehensive nursing intervention in the perioperative period, the SAS score and SDS score of patients after nursing were significantly lower than before （P<0.05）, the quality of life score was significantly higher than before （P<0.05）, and the nursing satisfaction rate was 88.24%. Conclusion Medpor implant through endoscopic transcaruncular approach is effective in the treatment of medial orbital fracture, with high surgical success rate and rare complications. Perioperative comprehensive nursing intervention can relieve patients' anxiety and depression and improve the quality of life, which is worthy of clinical promotion.
LIN Shanshan
,
CAI Meishi
,
ZHENG Xiaomin
,
ZHUANG Liping
. Perioperative comprehensive nursing of Medpor implant through endoscopic transcaruncular approach for medial orbital fracture[J]. Surgical Research and New Technique, 2025
, 14(2)
: 190
-194
.
DOI: 10.3969/j.issn.2095-378X.2025.02.021
[1] Alafaleq M, Roul-Yvonnet F, Schouman T, et al.A retrospective study of pure medial orbital wall fracture management[J]. J Fr Ophtalmol, 2019, 42(6): 592-596.
[2] Cha HG, Nam SM, Kim YB, et al.A comparative study of porous polyethylene versus absorbable polydextro- and polylevolactic-lactide plate in reconstruction of isolated medial orbital wall fracture[J]. J Plast Reconstr Aesthet Surg, 2022, 75(2): 782-787.
[3] Crozet A, Lebranchu P, Vabre B, et al.Management of orbital floor fractures in France: results of a national online survey[J]. J Stomatol Oral Maxillofac Surg, 2023, 124(3): 101389.
[4] Pitak-Arnnop P, Witohendro LK, Tangmanee C, et al.Assessing effectiveness of endoscope-assisted medial orbital wall fracture repair vs. no surgery using benefit-risk metrics and literature review[J]. J Stomatol Oral Maxillofac Surg, 2023, 124(1): 101267.
[5] Kim DH, Kim NR, Ko HS, et al.Barotraumatic blow-out fracture of the medial orbital wall by nose blowing[J]. J Craniofac Surg, 2021, 32(3): e265-e266.
[6] Tedaldi M, Vetrano S, Zotos G, et al.Management of orbital medial wall fracture with endonasal balloon[J]. J Craniofac Surg, 2023, 34(3): 1076-1077.
[7] Husain Q, Banks C, Bleier BS.Lynch vs transcaruncular approach: optimizing access to the lateral frontal sinus[J]. Int Forum Allergy Rhinol, 2020, 10(8): 991-995.
[8] Chang M, Yang SW, Park JH, et al.Using the endoscopic transconjunctival and transcaruncular approach to repair combined orbital floor and medial wall blowout fractures[J]. J Craniofac Surg, 2017, 28(4): 963-966.
[9] Chiu SJ, Tan JHY, Currie ZI.To implant or not to implant: emergency orbital eviscerations with primary orbital implants[J]. Eye (Lond), 2021, 35(11): 3077-3086.
[10] Pyo SB, Song JK, Ju HS, et al.Reconstruction of large orbital floor defect caused by maxillary sinus mucocele[J].Arch Craniofac Surg, 2017, 18(3): 197-201.
[11] Roslinah M, Wan Hitam WH, Md Salleh MS, et al.Comparison of clinical results and pathological examinations between locally synthesized bone-derived hydroxyapatite and Medpor® orbital implants in animal models[J]. Cureus, 2019, 11(1): e3954.
[12] 赵延祥. 鼻内镜下经筛窦治疗右眼眶内侧壁骨折伴内直肌嵌顿1例[J].实用医药杂志,2019,36(3):253-254.
