Abstract
ABSTRACT Posterior fractures of the orbital floor are challenging, since an incomplete visualization of the defect through conventional surgical accesses may compromise the surgical outcome. The use of the endoscope as an auxiliary method during orbital reconstructions may be considered as a tool of considerable importance, mainly due to the visualization of the whole extension of fracture and adaptation of meshes or bone grafts. This study aims to report a clinical case of a patient diagnosed with extensive blowout fracture showing diplopy, enophthalmos, and ophthalmoplegia in supraversion, who underwent a subciliary approach combined with transantral video assisted surgery. There were no intercurrences on the procedure. Currently, patient has 1 year of follow up, with reestablished orbital function and architecture.
Highlights
Facial fractures usually occur due to traumas of moderate and high energy, such as aggressions, car accidents, sports accidents, and fallings.[1]
The main goal of the surgical approach in these fractures is the tridimensional reconstruction of the lost bone anatomy through the reestablishment of the orbital volume.[7]. The subciliary, infra orbital, and transconjunctival incisions are the most used surgical accesses for this end.[8] some level of perioperative difficultness to view the whole defect is expected in extensive posterior bone defects, which can lead to an inadequate implant placement.[6] the combination of an endoscopic approach via maxillary sinus allows excellent assessment and visualization of the defect, providing a more effective reconstruction through the complete adaptation of the titanium mesh on the bone defect.[4,9]
The video assisted reconstruction of the orbital floor presents a few limitations and disadvantages.[2]. Sinus-related complications that occur due to the passage of the endoscope are rare and on most cases are associated to an unexperienced surgeon.[10]. The aim of the present study is to report a clinical case of a patient diagnosed with a blowout fracture that underwent orbital floor reconstruction through a subcilliary approach combined with an endoscopic technique due to the location and extension of the defect
Summary
Facial fractures usually occur due to traumas of moderate and high energy, such as aggressions, car accidents, sports accidents, and fallings.[1]. The video assisted reconstruction of the orbital floor presents a few limitations and disadvantages.[2] Sinus-related complications that occur due to the passage of the endoscope are rare and on most cases are associated to an unexperienced surgeon.[10] The aim of the present study is to report a clinical case of a patient diagnosed with a blowout fracture that underwent orbital floor reconstruction through a subcilliary approach combined with an endoscopic technique due to the location and extension of the defect.
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