title: Endoscopic endonasal management of medial orbital blowout fractures.
abstract: This study demonstrated that endoscopic endonasal sinus surgery is a successful technique for reducing medial orbital blowout fractures and does not cause complications. Twenty-three patients with isolated medial blowout fractures that did not involve the inferior wall underwent reduction surgery using the endoscopic endonasal approach. Surgery was indicated if the patient experienced persistent diplopia, ocular motility limitation, or enophthalmos. Septoplasty and submucous resection of the inferior turbinate bone were performed to access the fracture site safely in 3 and 15 patients, respectively. The bone fragments entrapping the orbital content or adhesions between the orbital contents and the sinus mucosa were dissected carefully from the fracture site. An ophthalmologist used the eye traction test to verify improvement in ocular motility. A temporary Silastic sheet was applied in three patients, but no permanent supporting material was used in any patient. No surgical or late complications were seen. Preoperative symptoms were resolved in 22 of the 23 (95.5%) patients 6 months after surgery. We concluded that the endoscopic endonasal reduction based on endoscopic endonasal sinus surgery techniques is safe, accurate, and an appropriate surgical intervention for medial orbital blowout fractures.
authors.affiliation: Department of Otolaryngology, Ehime University School of Medicine, Toon, Ehime, Japan. hinohira@m.ehime-u.ac.jp
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hinohira
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Takahashi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Komori
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiraishi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001672:Biocompatible Materials; D002648:Child; D004129:Dimethylpolysiloxanes; D004172:Diplopia / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D015841:Enophthalmos / Q000209:etiology; D005005:Ethmoid Sinus / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D009300:Nasal Septum / Q000601:surgery; D015835:Ocular Motility Disorders / Q000209:etiology; D009917:Orbital Fractures / Q000601:surgery*; D019919:Prosthesis Implantation; D019651:Plastic Surgery Procedures / Q000379:methods*; D000267:Tissue Adhesions / Q000601:surgery; D014420:Turbinates / Q000601:surgery; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; D004129:Dimethylpolysiloxanes; C013830:baysilon