Endoscopic versus external repair of orbital blowout fractures.
OBJECTIVE
This study evaluates the usefulness of endoscopic repair compared to external repair in the treatment of blowout fracture (BOF) of the orbit.


METHODS
This retrospective study comprised 100 patients who had had surgical repair of orbital BOF since 1992. Forty-eight of the 100 had undergone endoscopic repair, 48 patients had had external repair, and four patients underwent surgery that combined the two approaches. The two basic approaches were evaluated and compared with respect to technique, results and complications.


RESULTS
Endoscopically, transnasal and transantral approaches had been used for reduction and support of fractured medial and inferior walls, respectively. In the external approach, various transorbital incisions were made and the fractured wall was repaired with alloplastic or autologous materials. Complete or partial resolution of preoperative diplopia was achieved in 94% of the endoscopic group and 83% of the external group (NS). Enophthalmos was improved in 89% of the endoscopic group and 76% of the external group (NS). Though the endoscopic group had no significant complications, the external group had ectropions, significant facial scars, extrusion of inserted Medpor, and intra-orbital hematoma.


CONCLUSIONS
Endoscopic repair appears to be a safe and effective technique for the treatment of BOF of the orbit.
Jin
Hong-Ryul
HR
Department of Otorhinolaryngology, Seoul National University Boramae Hospital, Dongjak-Gu, Seoul, Korea. hrjin@paran.com
Yeon
Je-Yeob
JY
Shin
See-Ok
SO
Choi
Young-Seok
YS
Lee
Dong-Wook
DW
D000328:Adult; D004172:Diplopia / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D015841:Enophthalmos / Q000209:etiology; D005260:Female; D005557:Formaldehyde / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D009917:Orbital Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014792:Visual Acuity
D006490:Hemostatics; D005557:Formaldehyde; C027490:polyvinyl alcohol formaldehyde foam; D011142:Polyvinyl Alcohol