Endoscopic endonasal or transmaxillary repair of orbital floor fracture: a study of 88 patients treated in our department.
OBJECTIVE
Endoscopic repairs of orbital floor fractures performed in our department were reviewed and postoperative outcomes were assessed.


METHODS
The subjects comprised 88 patients who underwent surgery between 1991 and 2001, 14 of whom had trapdoor fractures. Endoscopic repair was performed when diplopia did not improve after 1 week of conservative treatment. Fractures were repaired via endonasal or transmaxillary routes and fixed with a urinary bladder catheter.


RESULTS
The postoperative course was evaluated on the basis of change in diplopia. After surgery, diplopia resolved in 79.5% of patients but remained, especially on upward gaze, in 20.5% of patients. Residual diplopia was more common in patients with trapdoor fracture.


CONCLUSIONS
Endoscopic endonasal and transmaxillary repairs were effective and less invasive methods for freeing orbital tissues trapped by fragments of fractured bone and for restoring smooth ocular movements. However, suspected trapdoor fractures should be repaired within 1 week after injury in order to prevent fibrosis from developing in orbital tissues owing to entrapment by bone fragments.
Otori
Nobuyoshi
N
Department of Otorhinolaryngology, Jikei University Hospital, Tokyo, Japan. otorinob@bj.mbn.or.jp
Haruna
Shinichi
S
Moriyama
Hiroshi
H
D000293:Adolescent; D000328:Adult; D000368:Aged; D002404:Catheterization / Q000379:methods; D002648:Child; D002675:Child, Preschool; D004172:Diplopia / Q000209:etiology* / Q000628:therapy; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery; D008875:Middle Aged; D009296:Nasal Cavity / Q000601:surgery; D009917:Orbital Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome