Feasibility Study for Transnasal Endoscopic Repair of Orbital Floor Fracture With Alloplastic Implant.
OBJECTIVE
Fractures of the orbital floor are common yet repaired by various techniques, including open periorbital, transantral endoscopic, and endoscopic endonasal approaches. To date, endoscopic endonasal repair of an orbital floor fracture using an alloplastic implant has not been described. We aim to determine the technique and limitations of completely endoscopic endonasal orbital floor repair using an alloplastic implant.


METHODS
Cadaveric anatomic study and retrospective case series.


METHODS
Cadaveric study of 12 sides with endoscopic sinonasal dissection followed by the creation and repair of an isolated orbital floor fracture using an alloplastic implant. Four representative patient cases are presented in which the techniques developed in the cadaveric study were employed. Patients were selected for this technique based on the results of the cadaveric study.


RESULTS
Cadaveric study demonstrated feasibility of access and repair for fractures that did not extend lateral to the infraorbital canal or anterior to the nasolacrimal duct. In all cadaveric sides and in all 4 patient cases, successful alloplastic orbital floor reconstruction was achieved.


CONCLUSIONS
This method of repair is feasible for selected patients and may be considered in cases of favorable fracture anatomy with or without concomitant indication for an ipsilateral sinus procedure.
Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, New York, USA.
Robert D
RD
Engle
Albany Medical College, Albany, New York, USA.
Mark
M
Chaskes
Division of Ophthalmic Plastic Surgery, Department of Ophthalmology, Albany Medical College, Albany, New York, USA.
Edward
E
Wladis
Division of Otolaryngology/Head and Neck Surgery, Department of Surgery, Albany Medical Center, Albany, New York, USA pinheic@mail.amc.edu.
Carlos D
CD
Pinheiro-Neto
D000293:Adolescent; D000368:Aged; D002102:Cadaver; D015331:Cohort Studies; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods*; D009917:Orbital Fractures / Q000000981:diagnostic imaging / Q000601:surgery*; D020959:Polyethylene; D019736:Prostheses and Implants; D019919:Prosthesis Implantation / Q000379:methods*; D019651:Plastic Surgery Procedures; D014057:Tomography, X-Ray Computed; D055815:Young Adult
D020959:Polyethylene
endoscopic endonasal; orbital floor fracture; rigid reconstruction