Patient satisfaction with ocular prosthesis was relatively high. Successful peg insertion to improve the prosthesis movement may be one way for surgeons to increase patient satisfaction.

Purpose: To evaluate the efficacy of endoscopic endonasal primary conjunctivodacryocystorhinostomy (CDCR) and revision CDCR after primary CDCR. Methods: Twenty-four patients who had undergone endoscopic endonasal CDCR with a Jones tube and who were followed up for over 6 months at our hospital were reviewed retrospectively. Our analysis included success rate, operation times, and causes of failure. Results: The indications for revision CDCR were Jones tube prolapse and inadequate tube length. The initial success rate in the primary and revision groups were 78.6% (11/14) and 100% (10/10), respectively, and their mean operation times were 24 min (± 6.3) and 21 min (± 6.1), respectively. Main causes of failure included inaccurate tube length and abnormal tube position. Conclusions: Endoscopic endonasal CDCR appears to be a reasonable revision and primary approach, because it allows Jones tube length to be measured accurately during surgery, and an 18- to 20-mm Jones tube length was used in most cases.

No abstract

In order to describe the demographics, etiologic and clinical factors, and outcomes of orbital fractures in children, we have reviewed a case series of 17 patients under 18 years of age with internal orbital fractures (i.e., without involvement of the orbital rim) presenting to the Ghil hospital between March 2000 and June 2001. For 15 of the patients, we performed orbital wall reconstruction with Medpor barrier sheet implantation (thickness 1mm) through transconjunctival approach under endoscopic guidance, while maintaining mere observation on the other 2 patients. There were 14 male and 3 female patients. The most common cause of fractures was accident (7 cases). Inferior wall involvement was most commonly seen, and the trapdoor type fracture was the most common. Thirteen patients had extraocular muscle restriction, 9 had nausea/vomiting and 5 had bradycardia. Diplopia of 9 patients disappeared after 43 +/- 23 days. Nausea/vomiting and bradycardia disappeared rapidly after surgical intervention in all cases. These results suggest that trapdoor fractures with soft tissue entrapment are the most common in pediatric orbital wall fractures, and that most of them are associated with nausea/vomiting. We suggest that early diagnosis, and prompt surgical intervention are required for those patients with oculocardiac reflex.