Endoscopic repair of orbital blowout fractures: Use or misuse of a new approach?

D Gregory Farwell, Bryan S. Sires, J. David Kriet, Robert B. Stanley

Research output: Contribution to journalArticle

14 Scopus citations

Abstract

Objective: To evaluate the successes and challenges of endoscopic orbital floor fracture repairs. Methods: We analyzed 53 orbital floor repairs and recorded the indications for surgery, factors that complicated the endoscopic repair or necessitated conversion to an open approach, and outcomes for each. Results: Forty-five procedures were completed endoscopically. Repairs of smaller injuries confined entirely to the medial floor were readily accomplished, particularly when entrapment was the primary indication for surgery. Endoscopic repair became very difficult and often not possible when a large amount of soft tissue was herniated through the floor defect and when dissection medially onto the lamina papyracea and lateral to the infraorbital nerve was required for implant placement. Duration of follow-up was short for some patients, but no adverse trends in outcomes were identified. Conclusions: Blowout fractures can be approached endoscopically. However, the technical challenge of working from below with a telescope tends to increase the difficulty of many repairs without improving results. Most blowout fractures are probably still best treated through an open approach, assuming that the lower eyelid incision is correctly performed.

Original languageEnglish (US)
Pages (from-to)427-433
Number of pages7
JournalArchives of Facial Plastic Surgery
Volume9
Issue number6
DOIs
StatePublished - Nov 2007

ASJC Scopus subject areas

  • Surgery

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