title: Assessment of indications and clinical outcome for the endoscopy-assisted combined subciliary/transantral approach in treatment of complex orbital floor fractures.
abstract: BACKGROUND
  The treatment of complex orbital floor fractures with extensive orbital prolapse remains a surgical challenge in craniomaxillofacial traumatology and is still controversially discussed. Reduction of orbital tissue via a transcutaneous or transconjunctival approach alone can be very difficult and lead to unsatisfying results.
  
  
  METHODS
  Over a 3-year-period, we enrolled 13 patients who underwent endoscopy-assisted reconstruction of isolated orbital floor fractures via a combined subciliary and transantral approach. Patient data, imaging and ophthalmologic examination were reviewed prospectively.
  
  
  RESULTS
  Ten patients underwent primary surgical treatment, 3 patients had secondary surgical treatment because of unsatisfactory results of primary surgical intervention. All patients had an uneventful postoperative course without ophthalmologic deterioration, no further surgical procedures were necessary.
  
  
  CONCLUSIONS
  The additional use of an endoscopy-assisted transantral approach provides a reliable treatment modality in selected cases. To our knowledge, this is the only study of patients treated with a combined subciliary and transantral approach. Special emphasis was given to postoperative functional results, a short algorithm for use of an additional transantral endoscopy-assisted approach is presented.
authors: Department of Oral and Maxillofacial Plastic Surgery, Tuebingen University Hospital, Osianderstrasse 2-8, 72076 Tuebingen, Germany. Electronic address: Joachim.polligkeit@med.uni-tuebingen.de.
authors: Joachim
authors: J
authors: Polligkeit
authors: Martin
authors: M
authors: Grimm
authors: Jens P
authors: JP
authors: Peters
authors: Marcel
authors: M
authors: Cetindis
authors: Michael
authors: M
authors: Krimmel
authors: Siegmar
authors: S
authors: Reinert
mesh_terms: D020341:Absorbable Implants; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001672:Biocompatible Materials / Q000737:chemistry; D004172:Diplopia / Q000209:etiology; D004724:Endoscopy / Q000379:methods*; D015841:Enophthalmos / Q000209:etiology; D005143:Eyelids / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008443:Maxillary Sinus / Q000601:surgery; D008875:Middle Aged; D009917:Orbital Fractures / Q000601:surgery*; D010292:Paresthesia / Q000209:etiology; D016687:Polydioxanone / Q000737:chemistry; D011100:Polyglycolic Acid / Q000737:chemistry; D011391:Prolapse; D011446:Prospective Studies; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation; D013526:Surgical Mesh; D014025:Titanium / Q000737:chemistry; D014057:Tomography, X-Ray Computed / Q000379:methods; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D001672:Biocompatible Materials; C460779:Ethisorb; D011100:Polyglycolic Acid; D016687:Polydioxanone; D014025:Titanium
keywords: Endoscopy; Fracture; Orbital; Subciliary; Transantral