Endoscopic transantral orbital floor repair with antral bone grafts

Objective: To evaluate the endoscopic transantral insertion of antral bone grafts into,,the orbit for repair of orbital floor defects. Design: A retrospective analysis with a mean follow-up of 5.3 months. Patients: Eleven patients who, underwent surgical repair of orbital floor fractures. Setting: Municipal hospital. Main Outcome Measures: Preoperative and postoperative Hess screen tests and the presence of diplopia, enophthalmos, donor site complications, cosmetic deformity, infection, and graft extrusion. Results: Subjectively, 3 patients with diplopia had complete resolution of their symptoms after surgery, and 8 patients had improvement of their symptoms. Objectively, 11 patients had significant improvement in the postoperative Hess area ratio compared with the preoperative-Hess area ratio. In 1 patient with a floor defect measuring 2.5 cm, enophthalmos existed after surgery, but reoperation was not performed in this case because diplopia was improved. There were no donor site complications, cosmetic deformity, infection, or graft extrusion. Conclusions: The endoscopic transantral insertion of antral bone grafts through the floor defect into the orbit is an effective technique that prevents injury to the lower eyelid, carries minimal donor site morbidity,,and provides an optimal support function for the globe. It merits consideration in cases of orbital defects less than 2 cm in diameter.