title: Isolated lesion of the medial orbital wall following endonasal surgery. Isolated fractures of the medial orbital wall.
abstract: 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.
authors.affiliation: Casa di cura Villa Verde, Bologna, Italy.
authors.forename: G
authors.initials: G
authors.lastname: Scassellati-Sforzolini
authors.forename: C
authors.initials: C
authors.lastname: Cavina
authors.forename: B
authors.initials: B
authors.lastname: Scassellati-Sforzolini
authors.forename: F
authors.initials: F
authors.lastname: Vancini
authors.forename: C
authors.initials: C
authors.lastname: Cavina
mesh_terms: 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