The Endoscopic Treatment of Blow-out Fracture

Abstract

Blow-out fracture is frequently encountered in facial bone trauma. It used to be reduced through sucilliary or transconjunctival incisions. But the field of orbital surgery is difficult due to lack of visualization of fracture site, blind dissection of orbital floor, susceptibility of injury of orbital structures. Recently, endoscopic reduction of orbital wall was provided good functional and cosmetic results. In order to address this shortcoming we have explored the use of endoscopic transantral approach in orbital floor dissection to allow direct visualization of orbital content and whole fracture components. We performed endoscopic transantral approach with or without subcilliary incision in 10 cases of blow-out fracture under general anesthesia. To accomplish this technique, a rigid 4mm, 0 or 30 degree angled endoscopy was inserted into the maxillary sinus. The operative field in maxillary sinus was kept visually clear by saline irrigation and fine suction. For the maintain of the position of fractured site, urinary balloon foley catheter were used in fracture site for 2 weeks. There was no specific complications related to this procedure. Result of surgery in all cases were satisfactory. We discussed the surgical procedure, the advantages of the transantral endoscopic approach.