Endoscopic repair of orbital blow-out fractures

Abstract

Orbital floor blow-out fractures occur in repeatable patterns that can be classified as either medial or lateral to the infraorbital nerve. Medial fractures are the most common and are amenable to endoscopic repair, while lateral fractures are not. The keys to successful surgical repair of these injuries are adequate exposure, complete visualization of the entire fracture, and anatomic repair of the defect. Visualization of the posterior shelf is often challenging through traditional transconjunctival and subciliary incisions. These approaches also have known risks of postoperative eyelid malposition. The transmaxillary endoscopic approach to orbital blow-out fractures offers excellent visualization of the entire orbital floor. Fracture types can be evaluated and anatomically repaired without the need for an eyelid incision. Although this is a new and evolving technique, early experience suggests that the endoscopic approach is a safe, efficacious technique for orbital blow-out fracture repair. It offers improved visualization, anatomic fracture repair, no risk of postoperative eyelid complications, and good clinical results.