Endoscopic endonasal repair of orbital floor fracture.

BACKGROUND High-resolution endoscopes and the advent of endoscopic instruments for sinus surgery provide surgeons with excellent endonasal visualization and access to the orbital walls. OBJECTIVE To demonstrate repair of orbital floor blowout fractures through an intranasal endoscopic approach that allows repair of the orbital floor fracture and elevation of the orbital content using a balloon catheter without an external incision. DESIGN This study was a retrospective analysis of 11 patients who underwent surgical repair of orbital floor fractures from September 1994 to June 1997. There were 10 male patients and 1 female patient, aged 12 to 32 years (mean age, 24 years). These patients had undergone primary repair of pure orbital blowout fractures and were followed up at least 6 months after surgery. RESULTS There were no intraoperative or postoperative complications. Nine patients showed a complete improvement of their diplopia. Two patients with posterior fractures showed persistent diplopia, which was well managed by prisms. CONCLUSION Endoscopic repair of the orbital floor blowout fracture using an endonasal approach appears to be a safe and effective technique for the treatment of diplopia.