THE ENDOSCOPIC TREATMENT OF ORBITAL FLOOR FRACTURE

Park, Dae Hwan; Lee, Jae Woo; Han, Dong Gil; Ahn, Ki Young

Abstract

Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of fracture site, blind dissection of orbital floor. In ordeal to address this shortcoming we haute explored the use of endoscopic techniques In orbital floor dissection to allow dialect visualization of incarcerated soft tissue and entice entire fracture components. We have applied this technique in 9 clinical cases without complication. To accomplish this technique, a rigid 4mm, 30 degree down-angled endoscopy was inserted into not only the maxillary sinus but also the orbit. The operating field in the maxillary sinus was kept visually clear by infusing saline, fine suction and irrigation. Other surgical instruments used included a antrum trocar with cannula, small forcep, rongeurs, Freer periosteal elevators, fine suction tip. The postoperative courses were satisfactory in all cases. The use of endoscope provided an expanded field of vision, direct manipulation of herniated orbital soft tissue and allowed us to make the accurate realignment with exact replacement of orbital component.