Skip to main content
Log in

Endoscopic Management of Orbital Fractures

  • Facial Trauma (R. Kellman, Section Editor)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

The main indications for surgical correction of orbital fracture are diplopia, enophthalmos, signs of herniation of orbital contents into the ethmoid and maxillary sinuses, orbital muscle incarceration leading to reduced ocular motility, decreased visual acuity, persistent infraorbital hypoesthesia, and hypo-ophthalmia. The location of the fracture is important in determining the treatment approach. Endoscopic repair of orbital fractures has received increased attention since the development of better endoscopic materials and high-tech fiberoptics. This article reviews the endoscopic treatment of orbital fractures.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

References of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Kontio R, Lindqvist C. Management of orbital fractures. Oral Maxillofacial Surg Clin N Am. 2009;21:209–20.

    Article  Google Scholar 

  2. Manolidis S, Weeks BH, Kirby M, Scarlett M, Hollier L. Classification and surgical management of orbital fractures: experience with 111 orbital reconstructions. J Craniofac Surg. 2002;13:726–37.

    Article  CAS  PubMed  Google Scholar 

  3. Meningaud JP, Pitak-Arnnop P, Bertrand JC. Endoscope- assisted repair of medial orbital wall fractures using a retrocaruncular approach. J Oral Maxillofac Surg. 2007;65(5):1039–43.

    Article  PubMed  Google Scholar 

  4. Hinohira Y, Hyodo M. Endoscopic endonasal reduction surgery for diplopia caused by orbital roof fractures. J Plast Reconstr Aesthet Surg. 2009;62(10):e345–8.

    Article  PubMed  Google Scholar 

  5. Wu W, Jing W, Selva D, Cannon PS, Tu Y, Chen B. Endoscopic transcaruncular repair of large medial orbital wall fractures near the orbital apex. Ophthalmology. 2013;120(2):404–9.

    Article  PubMed  Google Scholar 

  6. Ducic Y, Verret DJ. Endoscopic transantral repair of orbital floor fractures. Otolaryngol Head Neck Surg. 2009;140(6):849–54.

    Article  PubMed  Google Scholar 

  7. Ezzat WF, El-Hasan MA, Rabie H. Validity and accuracy of subciliary endoscopic-aided repair of orbital floor fractures. Eur Arch Otorhinolaryngol. 2011;268(6):935–40.

    Article  CAS  PubMed  Google Scholar 

  8. • Hundepool AC, Willemsen MAP, Koudstaal MJ, van der Wal KGH. Open reduction versus endoscopically controlled reconstruction of orbital floor fractures: a retrospective analysis. Int J Oral Maxillofac Surg 2012;41:489–493. This retrospective study with 83 patients concludes that endoscopically controlled reconstruction provides, besides improved visualization, confirmation of correct implant placement, and reduction of herniated orbital tissues; In the two groups, postoperative diplopia was found in 34% of group 1 (open reduction repair of the orbital floor fracture) and 16% of group 2 (open reduction and endoscopically controlled repair).

  9. Ballin CR, Sava LC, Maeda CA, Nogueira GF, Jebahi Y, Sava HW, Koladicz KR. Endoscopic transnasal approach for treatment of the medial orbital blowout fracture using nasal septum graft. Facial Plast Surg. 2009;25(1):3–7.

    Article  CAS  PubMed  Google Scholar 

  10. Kim K, Song K, Choi S, Bae Y, Choi C, Oh H, Lee J, Nam S. Endoscopic transnasal approach for the treatment of isolated medial orbital blow-out fractures: a prospective study of preoperative and postoperative orbital volume change. Ann Plast Surg. 2012;68(2):161–5.

    Article  CAS  PubMed  Google Scholar 

  11. Han K, Choi JH, Choi TH, Jeon SY, Kim JS, Kim NG, Lee KS, Son D, Kim JH, Kim SH, Kang D, Park J. Comparison of endoscopic endonasal reduction and transcaruncular reduction for the treatment of medial orbitalwall fractures. Ann Plast Surg. 2009;62(3):258–64.

    Article  CAS  PubMed  Google Scholar 

  12. Lee DG, Cho KS, Kim HJ, Roh HJ. Cerebrospinal fluid rhinorrhoea as a complication of endoscopic endonasal reduction of blowout fractures. J Laryngol Otol. 2012;126(9):942–5.

    Article  PubMed  Google Scholar 

  13. Wu W, Yan W, Cannon PS, Jiang AC. Endoscopic transethmoidal and transconjunctival inferior fornix approaches for repairing the combined medial wall and orbital floor blowout fractures. J Craniofac Surg. 2011;22(2):537–42.

    Article  PubMed  Google Scholar 

  14. Bly RA, Chang SH, Cudejkova M, Liu JJ, Moe KS. Computer guided orbital reconstruction to improve outcomes. JAMA Facial Plast Surg. 2013;15(2):113–20.

    Article  PubMed  Google Scholar 

  15. Shi W, Jia R, Li Z, He D, Fan X. Combination of transorbital and endoscopic transnasal approaches to repair orbital medial wall and floor fractures. J Craniofac Surg. 2012;23(1):71–4.

    Article  PubMed  Google Scholar 

  16. Jin HR, Yeon JY, Shin SO, Choi YS, Lee DW. Endoscopic versus external repair of orbital blowout fractures. Otolaryngol Head Neck Surg. 2007;136(1):38–44.

    Article  PubMed  Google Scholar 

  17. Lee TH, Lee HM, Lee JM, Nam JG. Endoscopic reduction of orbital medial wall fracture using rotational repositioning of the fractured: laminapapyracea fragment. J Craniofac Surg. 2014;25(2):460–2.

    Article  PubMed  Google Scholar 

  18. Converse J, Firmin F, Wood-Smith D. The conjunctival approach in orbital fractures. Plast Reconstr Surg. 1973;52:656–7.

    Article  CAS  PubMed  Google Scholar 

  19. Burnstine MA. Clinical recommendations for repair of isolated orbital floor fractures: an evidence-based analysis. Ophthalmology. 2002;109:1207.

    Article  PubMed  Google Scholar 

  20. Cheong EC, Chen CT, Chen YR. Broad application of the endoscope for orbital floor reconstruction: long-term follow-up results. Plast Reconstr Surg. 2010;125(3):969–78.

    Article  CAS  PubMed  Google Scholar 

  21. Simmons O, Manson PN. Endoscopic management of orbital and frontal sinus fractures. Craniomaxillofac Trauma Reconstr. 2009;2(3):177–84.

    Article  PubMed Central  PubMed  Google Scholar 

  22. •• Cheung K, Voineskos SH, Avram R, Sommer DD. A systematic review of the endoscopic management of orbital floor fractures. JAMA Facial Plast Surg 2013;15(2):126–130. In this systematic review with 172 patients, rates of resolution of diplopia and enophthalmos on the endoscopic approach were 86% and 95%, respectively; Complication rates were low; No major complications reported.

  23. Nishiike S, Nagai M, Nakagawa A, Konishi M, Kato T, Sakata Y, Yasukura T, Harada T. Endoscopic transantral loor repair with antral bone grafts. Arch Otolaryngol Head Neck Surg. 2005;131(10):911–5.

    Article  PubMed  Google Scholar 

  24. Moore CC, Bromwich M, Roth K, Matic DB. Endoscopic anatomy of the orbital floor and maxillary sinus. J Craniofac Surg. 2008;19(1):271–6.

    PubMed  Google Scholar 

  25. Yan Z, Zhou Z, Song X. Nasal endoscopy-assisted reconstruction of orbital floor blowout fractures using temporal fascia grafting. J Oral Maxillofac Surg. 2012;70(5):1119–22.

    Article  PubMed  Google Scholar 

  26. Courtney DJ, Thomas S, Whitfield PH. Isolated orbital blowout fractures: survey and review. Br J Oral Maxillofac Surg. 2000;38(5):496–504.

    Article  CAS  PubMed  Google Scholar 

  27. Fernandes R, Fattahi T, Steinberg B, Schare H. Endoscopic repair of isolated orbital floor fracture with implant placement. J Oral Maxillofac Surg. 2007;65(8):1449–53.

    Article  PubMed  Google Scholar 

  28. Guerra MF, Perez JS, Rodriguez-Campo FJ, et al. Reconstruction of orbital fractures with dehydrated human dura mater. J Oral Maxillofac Surg. 2000;58(12):1361.

    Article  CAS  PubMed  Google Scholar 

  29. Strong EB. Endoscopic repair of orbital blow-out fractures. Arch Facial Plast Surg. 2004;20:223.

    Article  Google Scholar 

  30. Polligkeit J, Grimm M, Peters JP, Cetindis M, Krimmel M, Reinert S. Assessment of indications and clinical outcome for the endoscopy-assisted combined subciliary/transantralapproach in treatment of complex orbital floor fractures. J Craniomaxillofac Surg. 2013;41(8):797–802.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Carlos Roberto Ballin.

Additional information

This article is part of the Topical Collection on Facial Trauma.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Ballin, C.R., Sava, L.C., Dassi, C.S. et al. Endoscopic Management of Orbital Fractures. Curr Otorhinolaryngol Rep 3, 233–237 (2015). https://doi.org/10.1007/s40136-015-0094-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s40136-015-0094-9

Keywords

Navigation