Endoscopic approach to orbital blowout fracture repair.
OBJECTIVE
Transconjunctival and subciliary approaches to orbital floor blowout fractures (OBF) have known risks of postoperative eyelid malposition. This study evaluates the endoscopic transmaxillary repair of OBFs in a cadaveric model and clinical setting.


METHODS
Sixteen cadaveric and 10 clinical OBFs were repaired endoscopically. A Caldwell-Luc approach and modified sinus surgery instrumentation were used to repair each fracture. Variations in fracture pattern, instrumentation, and surgical technique were evaluated.


RESULTS
Endoscopic repair was achieved in all 16 cadaveric orbits and in 9 of 10 patients. Fracture patterns were classified as either medial or lateral to the infraorbital nerve. Average clinical operating time was 1:38. Of 9 postoperative CT scans, 5 were rated as excellent, 3 as good, and 1 as poor.


CONCLUSIONS
The endoscopic transmaxillary approach is a safe, viable technique for OBF repair. It offers improved visualization, anatomic fracture repair, no risk of postoperative eyelid complications, and good clinical results.


METHODS
C.
Strong
E Bradley
EB
Department of Otolaryngology, University of California Davis School of Medicine, Sacramento, CA 95817, USA.
Kim
Kenneth K
KK
Diaz
Rodney C
RC
D000293:Adolescent; D000328:Adult; D002102:Cadaver; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D009917:Orbital Fractures / Q000601:surgery*; D013517:Otorhinolaryngologic Surgical Procedures / Q000379:methods*; D016896:Treatment Outcome