Abstract
Revisional surgery of nasoethmoidal orbital injuries is best accomplished when the original injury can be recreated. The involved facial skeleton is accessed through remote incisions, fractures sites are recreated by osteotomy, missing or deformed bone is replaced, and the realigned skeleton is stabilized with rigid fixation. Key maneuvers in this process include transnasal reduction and fixation of the medial canthal-bearing fragment of the medial orbital rim, reconstruction of the medial internal orbit, and nasal bone grafting. The aesthetic result of these surgeries is usually limited by soft-tissue scarring and contracture from the original injury and previous surgical interventions.
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