Transnasal Endoscopic Reconstruction of Medial Orbital Wall Fracture

Bai, Chang Hoon; Ye, Sang Baik; Park, Kang Shik; Song, Si Youn; Kim, Yong Dae

Abstract

BACKGROUND AND OBJECTIVES
Before introducing transnasal endoscopic sinus surgery, surgical repair of the blowout fracture includes the transorbital approach with an external incision and/or the maxilloethmoidal approach. The advantages of the transnasal endoscopic technique include magnified direct visualization and easy access to the medial orbital walls. Gelfoam is a slowly absorbable material and is rigid enough to provide support where Silastic sheet is to be placed. The purpose of this study was to evaluate outcomes of transnasal endoscopic reconstruction with Gelfoam and Silastic sheet of medial orbital wall fracture. SUBJECTS AND METHOD: This study was a retrospective analysis 27 patients who underwent transnasal endoscopic reduction of blowout fracture from February 1999 to April 2004. The follow-up period was at least over than 12 months. RESULTS: The study population included 18 males and 9 female patients ranging from 13 to 54 years (mean, 33.3 years) of age. Twenty of 23 patients with diplopia showed a complete improvement of diplopia and 3 patients showed an incomplete improvement. All of 13 patients with limitation of ocular movement and 2 patients with enophthalmos revealed a complete resolution of their symptoms. There were no significant complications in all patients although ocular pain and epiphora were observed temporally after operation. CONCLUSION: Transnasal endoscopic reconstruction with Gelfoam and Silastic sheet for medial orbital wall fracture is a very successful technique that does not accompany major complications and has definite cosmetic advantage of causing no external scarring.