title: Successful application of endoscopic modified medial maxillectomy to orbital floor trapdoor fracture in a pediatric patient.
abstract: Although surgical treatment of orbital floor fractures can be performed by many different approaches, the application of endoscopic modified medial maxillectomy (EMMM) for this condition has rarely been described in the literature. We report on a case of a 7-year-old boy with a trapdoor orbital floor fracture successfully treated with the application of EMMM. The patient suffered trauma to the right orbit floor and the inferior rectus was entrapped at the orbital floor. Initially, surgical repair via endoscopic endonasal approach was attempted. However, we were unable to adequately access the orbital floor through the maxillary ostium. Therefore, an alternative route of access to the orbital floor was established by EMMM. With sufficient visualization and operating space, the involved orbital content was completely released from the entrapment site and reduced into the orbit. To facilitate wound healing, the orbital floor was supported with a water-inflated urethral balloon catheter for 8 days. At follow-up 8 months later, there was no gaze restriction or complications associated with the EMMM. This case illustrates the efficacy and safety of EMMM in endoscopic endonasal repair of orbital floor fracture, particularly for cases with a narrow nasal cavity such as in pediatric patients.
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Yasunori
authors.initials: Y
authors.lastname: Matsuda
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan. Electronic address: hsakaida@clin.medic.mie-u.ac.jp.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Sakaida
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Kobayashi
authors.affiliation: Department of Otorhinolaryngology - Head & Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan.
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Takeuchi
mesh_terms: D002648:Child; D004724:Endoscopy; D006801:Humans; D008297:Male; D008437:Maxilla / Q000601:surgery*; D009296:Nasal Cavity; D057605:Natural Orifice Endoscopic Surgery; D009801:Oculomotor Muscles / Q000293:injuries / Q000601:surgery*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D014057:Tomography, X-Ray Computed
keywords: Endoscopic modified medial maxillectomy; Fracture; Orbital floor; Pediatric; Surgery