眼窩底骨折整復術における上顎洞バルーン挿入術の合併症

Complications of balloon treatment in cases of orbital floor fracture

要約　目的：眼窩底骨折に対する上顎洞バルーン挿入術の合併症の報告。対象と方法：過去2年間に眼窩底骨折に対し，眼窩下縁の皮膚切開による骨折整復と上顎洞バルーン挿入術を受けた149例の診療録を検索した。年齢は15歳以上に限定した。バルーンは生理食塩水で拡張し，約2週間留置したのちに抜去した。結果：バルーンによる合併症は5例（3.3％）に生じた。バルーン抜去前の合併症は，バルーン破裂が2例，高眼圧が2例で，抜去後の合併症として上顎炎が1例に生じた。結論：眼窩底骨折に対する骨折整復と上顎洞バルーン挿入術は，術後早期に異常がなければ視機能に障害がなく，安全で有効である。

Abstract.　Purpose：To report complications of treatment of orbital floor fracture with adjunct use of balloon inserted in the maxillary sinus. Cases and Method：This retrospective study was made on 149 cases of orbital floor fracture treated during the past 2 years. Excluded were cases aged less than 14 years. As a standard procedure,the orbital floor was replaced through anterior transcutaneous approach. A balloon was then inserted into the maxillary sinus,was expanded by physiological saline,and was removed 2 weeks later. Results：Clinical course was uneventful in all the cases except 5 cases（3.3％）. The balloon ruptured in 2 cases,the intraocular pressure was elevated in 2 cases,and maxillary sinusitis developed after removal of balloon in one case. Conclusion：Surgical treatment of orbital floor fracture with adjunct use of balloon was safe and effective when there was no or minimal disorders shortly after surgery.