Endoscopic endonasal repair of blowout fracture

• Published in: JOURNAL OF JAPAN SOCIETY FOR HEAD AND NECK SURGERY Vol. 10; no. 1; pp. 71 - 77
• Main Authors: Hinohira, Yasuyuki, Yumoto, Eiji, Sadamoto, Akiko, Furutaguchi, Yutaka, Yanagihara, Naoaki, Sadamoto, Masanori, Shimamura, Ichiro
• Format: Journal Article
• Language: English
• Published: JAPAN SOCIETY FOR HEAD AND NECK SURGERY 2000
• Subjects: blowout fracture; endonasal surgery; intraoperative traction test; traction test
• ISSN: 1349-581X; 1884-474X
• DOI: 10.5106/jjshns.10.71

35 patients with blowout fracture were surgically treated between 1997 and 1999. We applied the endonasal approach to 29 of the 35 cases (medial fracture 11 and inferior fracture 18) using endoscope. Septoplasty on four and submucous conchotomy was complemented on 24 cases during surgery because of allergic rhinitis and acute/or chronic sinusitis. Bone fragments adhesive to the orbital contents protruded into the sinus were carefully removed. The periorbita was preserved as much as possible. Intraoperative traction test both after the repair as above mentioned and the temporary fixation using tampon gauze or balloon catheter was performed on all the patients to confirm the improvement of mobility of the eyeball. The result of the traction test related to the prognosis. Only three cases still showed slight diplopia postoperatively. This result indicates that endoscopic sinus surgery can be applied even to the orbital floor fracture.