Application of endoscope-assisted minimal-access techniques in orbitozygomatic complex, orbital floor, and frontal sinus fractures.
OBJECTIVE
Minimal-access endoscope-assisted techniques have been adapted for facial rejuvenation surgery over the past 5 years, allowing smaller incisions, limited dissection, and shorter recovery times. Their increasing popularity prompted the author to investigate their application in facial trauma patients.


METHODS
Endoscope-assisted minimal-access surgical approaches were developed in cadavers and applied in the management of frontal sinus, orbital floor, and orbitozygomatic complex fractures over a 3-year period. At a Level 1 regional trauma center, these techniques were applied in 33 of 161 patients with facial fractures. Surgical techniques, applications of endoscope technology, and indications/contraindications are presented. A technique, known as the pulse test, was developed for assessing the integrity of the orbital floor.


CONCLUSIONS
Endoscope-assisted minimal-access surgical techniques have a definite but perhaps limited application in the diagnosis, as well as in some aspects of the surgical treatment of fractures of the anterior table frontal sinus, orbitozygoma, and orbital floor. New indications for these techniques will depend upon the development of improved instrumentation.
Forrest
C R
CR
Hospital for Sick Children, Centre for Craniofacial Care and Research, Division of Plastic Surgery, Toronto, Ontario, Canada. christopher.forrest@sickkids.on.ca
D000293:Adolescent; D000328:Adult; D000368:Aged; D002102:Cadaver; D000075202:Contraindications; D004210:Dissection; D019723:Endoscopes; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D005593:Fracture Fixation, Internal / Q000295:instrumentation / Q000379:methods; D005626:Frontal Sinus / Q000293:injuries* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009917:Orbital Fractures / Q000145:classification / Q000601:surgery*; D012887:Skull Fractures / Q000601:surgery*; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015051:Zygomatic Fractures / Q000601:surgery*