Endoscopic transantral repair of orbital floor fractures

OBJECTIVE: To review our technique of endoscopic transantral repair of orbital floor fractures. STUDY DESIGN: Case series with chart review. METHODS: All orbital floor fractures treated with the outlined technique from 1999 to 2007 were reviewed in a retrospective fashion. Demographic data, surgical outcomes, and complications were gathered from available patient charts. RESULTS: A total of 63 patients were treated with the described technique (44 male, 19 female). Thirty-nine patients underwent autograft placement from the anterior maxillary sinus wall harvest/exposure. Fourteen patients underwent placement of various alloplasts, and the remaining 10 patients underwent reduction of the contents and floor repositioning. Two patients underwent repeat repair due to inadequacy of initial repair. Both of these complications occurred in the subgroup of patients who underwent simple repositioning. There were no cases of blindness, permanent now diplopia, ectropion, entropion, or new infraorbital anesthesia. CONCLUSIONS: The described technique of endoscopic repair of orbital floor fractures represents a precise method of fracture repair that results in excellent outcomes with minimal morbidity in the majority of patients. It allows for immediate fracture repair without the need to wait for periorbital edema to settle. It also allows for clear visualization of the entire fracture for precise graft placement. (C) 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation. All rights reserved.