Two Portal Approach(Endoscopic Transnasal and Subciliary) in Medial Orbital Wall Fracture.

Chang, Hyun; Dhong, Eun Sang; Won, Chang Hoon; Yoon, Eul Sik

Original Article

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2006;33(5):552-556.
Published online September 1, 2006.

Two Portal Approach(Endoscopic Transnasal and Subciliary) in Medial Orbital Wall Fracture.

Hyun Chang, Eun Sang Dhong, Chang Hoon Won, Eul Sik Yoon

Department of Plastic Surgery, Korea University College of Medicine, Gyoenggi-do, Korea. prsdhong@kumc.or.kr

Abstract

PURPOSE
As the use of computed tomographic scanning spread, the diagnosis of blow-out fractures of the medial orbital wall increased. Conventionally, the surgery of blow-out fractures in medial orbital wall was performed by various approaches with external incision or endoscopic approach. Although the field of orbital surgery has progressed significantly during the last decade, accurate realignment and replacement of component is difficult due to lack of visualization of the fracture site, blind dissection of the orbital wall, and difficulty in insertion of implant. In order to overcome these shortcomings, we explored the use of endoscopic transnasal approach together with subciliary approach. METHODS: The entrapped periorbital tissues in the ethmoid sinus were completely reduced endoscopically, and the bone defect of medial orbital wall was reconstructed with Medpor(R) insertion via subciliary approach. This technique was applied to 13 patients who had medial orbital wall fracture.
RESULTS
The patients were followed-up for 3 to 24 months with an average of 9 months. The postoperative courses were satisfactory in all cases.
CONCLUSION
The conjunction of endoscopic transnasal and subciliary approach technique seems to produce good results in medial orbital wall fracture.

Keywords: Blow-out fracture; Endoscopic; Transnasal; Subciliary