Endoscopic endonasal or transmaxillary repair of orbital floor fracture: a study of 88 patients treated in our department.

Abstract

Objective—Endoscopic repairs of orbital floor fractures performed in our department were reviewed and postoperative outcomes were assessed.Material and Methods—The subjects comprised 88 patients who underwent surgery between 1991 and 2001, 14 of whom had trapdoor fractures. Endoscopic repair was performed when diplopia did not improve after 1 week of conservative treatment. Fractures were repaired via endonasal or transmaxillary routes and fixed with a urinary bladder catheter.Results—The postoperative course was evaluated on the basis of change in diplopia. After surgery, diplopia resolved in 79.5% of patients but remained, especially on upward gaze, in 20.5% of patients. Residual diplopia was more common in patients with trapdoor fracture.Conclusions—Endoscopic endonasal and transmaxillary repairs were effective and less invasive methods for freeing orbital tissues trapped by fragments of fractured bone and for restoring smooth ocular movements. However, suspected trapdoor fractures should be repaired within 1 week after injury in order to prevent fibrosis from developing in orbital tissues owing to entrapment by bone fragments.