Videoimage endoscopy in surgical treatment of patients with upper orbital roof fractures

Abstract

The study objective is to assess the effectiveness and safety of videoimage endoscopy during minimally invasive surgery in fractures of the upper orbital roof.Materials and methods. We examined and operated 9 patients (7 men and 2 women) aged 16 to 53 years (mean age 28.4 years) with fractures of the upper orbital roof with intraorbital (n = 7) and intracranial (n = 2) fragments displacement. Surgery was aimed at eliminating oculomotor disorders, preventing purulent-septic complications and restoring tightness of the intracranial space and orbital anatomy. All patients were operated using 4 mm rigid endoscopes with 0 and 30° viewing angles.Results. All patients underwent fraction resection and intraorbital structures decompression. No case of intraoperative liquorrhea was registered. The surgery did not change visual acuity. Ocular motility disturbances were eliminated in all patients. Videoimage endoscopy made it possible to avoid wide craniotomy used to approach orbital roof and to shorten the rehabilitation period and hospitalization time. With intraorbital fragments displacement it allowed to reconstruct the orbit with minimal eyeball traction, while preserving important neurovascular bundles, as well as simultaneously revise dura mater and anterior cranial base in order to exclude intraoperative liquorrhea. No complications of surgical treatment were reported.Conclusion. The results demonstrate the wide possibilities of endoscopy in cranioorbital lesions surgery.Conflict of interest. The authors declare no conflict of interest.Informed consent. All patients gave written informed consent to participate in the study