Abstract
One of possible application s of CT navigated surgery in the ORL region is traumatology of facial skeleton. CT navigation in this area makes it possible to the surgeon to use the navigation probe for evaluation of the extent and quality of performed reposition and fixation of the fracture, here specifically the eye-socket base.
The procedure is based on preoperative CT VDN images with sections 1.5 - 2.0mm and subsequent registration. At our workplace surgery was performed for 28 blow-out fractures of eye-socket base in the period of 2007 - 2011.
In 21 cases we used the transantral approach and 7 times from the subciliary approach (under navigation in all cases). In the transantral approach the fractures were supported by a prop composed from a hydro plate and super acrylate lamina with a steel spiral.
In the subciliary approach we used PMR splint six times and a PDS splint once. We evaluated the postoperative placement, position, eyeball motility and the state of diplopia.
In the group of primary interventions without CT navigation from transantral approach, diplopia disappeared in 77% of patients completely and in 23% operated on fracture of an older date the diplopia continues only in the outside positions of visual field and is considered as clinically insignificant. In all surgically treated patients with CT navigation we reached a complete disappearance of diplopia and the correct position of the eyeball irrespective of the way of approach or the used fixation material.