Isolated lesion of the medial orbital wall following endonasal surgery. Isolated fractures of the medial orbital wall.
BACKGROUND
Isolated fractures of the medial orbital wall are infrequent. The diagnostic triad includes: adduction block, exotropia with diplopia in all directions of gaze, positive passive duction in abduction. Sometimes a slight enophthalmos is present. Computed tomography shows the extension and the seat of the fracture.


METHODS
The authors illustrate the case of a 60 year old male who presented with a breach of the medial orbital wall following endonasal surgery.


RESULTS
The patient was successfully operated using an iliac bone graft inserted via an eyebrow-nasal cutaneous approach, after a previous attempt with a transconjunctival approach performed in another hospital had failed. A good functional and aesthetic result was observed within the first year after surgery. After almost 11 years a full adduction is still present and diplopia is absent.


CONCLUSIONS
The authors underline the importance of an early diagnosis and prompt surgical treatment. The fat-muscle entrapment should be removed and the bone defect closed. A close cooperation between ophthalmologist and plastic surgeon is suggested.
Scassellati-Sforzolini
G
G
Casa di cura Villa Verde, Bologna, Italy.
Cavina
C
C
Scassellati-Sforzolini
B
B
Vancini
F
F
Cavina
C
C
D016025:Bone Transplantation; D004172:Diplopia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005099:Exotropia / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005133:Eye Movements; D005138:Eyebrows / Q000601:surgery; D005500:Follow-Up Studies; D006801:Humans; D007085:Ilium / Q000637:transplantation; D008297:Male; D008875:Middle Aged; D009300:Nasal Septum / Q000002:abnormalities / Q000601:surgery; D009801:Oculomotor Muscles / Q000293:injuries / Q000503:physiopathology; D009915:Orbit / Q000000981:diagnostic imaging / Q000293:injuries*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery; D012086:Reoperation; D012225:Rhinoplasty / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed